Novosti
Khirurgii

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Year 2019 Vol. 27 No 1

GENERAL & SPECIAL SURGERY

V.N. ZASIMOVICH, A.S. KARPITSKI, A.M. NAZARUK, YA.A. MALASHCHYTSKI, M.N. BARYSENKA, A.S. ZHYMAILA, A.I. ARLAVETS

RETROGRADE LOOP ENDARTERECTOMY IN ATHEROSCLEROTIC OCCLUSION OF THE FEMORAL ARTERY

Brest Regional Hospital, Brest,
The Republic of Belarus

Objective. To compare the immediate and long-term surgical treatment results of the superficial femoral artery occlusion by the retrograde loop endarterectomy and femoral-popliteal bypass grafting above the knee joint space with a synthetic prosthesis.
Methods. From 2011 to 2015, 192 revascularizations of the limb were performed in the atherosclerotic superficial femoral artery occlusion. Patients were divided into groups two depending on the revascularization technique: the 1st group (n=133) – patients who underwent the retrograde loop endarterectomy, the 2nd group (n=59) – patients who underwent femoral-popliteal bypass grafting above the knee joint space.
Results. Technical success was obtained in 100% of observations. After revascularization, the increase in the mean value of the ankle-brachial index was 0.43±0.03 in the group I, 0.41±0.04 in the group II (M±σ). Thrombosis of the desublimated segment developed in 6 patients (4.5%) of the Group I, thrombosis of the shunt – in 3 patients (5.1%) of the Group II. Long-term results were studied in the terms of 1-3 years. Survival rate after 1 year and 3 years in the group I was 97.7% è 92.5% respectively, in the group II – 98.3% è 91.5%.
Primary patency in the group I after 1 and 3 years made up 89.5% and 64.7% respectively, in the group II – 74.6% and 49.2%.
The primary level of limb preservation in the group I after 1 and 3 years was 94.0% and 85.0%, respectively. And in the group II, the same indicator was noticeably lower, and in 1 and 3 years was 84.7% and 62.7%, respectively.
Conclusions. The retrograde loop endarterectomy shows better results in the postoperative and distant periods compared to femoral-popliteal bypass grafting above the knee joint with a synthetic prosthesis. Retrograde looped endarterectomy can be the operation of choice in case of primary surgical intervention on isolated atherosclerotic occlusion of superficial femoral artery.

Keywords: atherosclerosis, femoral artery occlusion, retrograde loop endarterectomy, femoral-popliteal bypass grafting, revascularization
p. 35-41 of the original issue
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Address for correspondence:
224027, The Republic of Belarus,
Brest, Meditsinskaya Str., 7,
Brest Regional Hospital,
Unit of Vascular Surgery.
Tel.: +375 162 27-23-64,
e-mail: zasimovich.v@gmail.com,
Vladimir N. Zasimovich
Information about the authors:
Zasimovich Vladimir N., Head of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
https://orcid.org/0000-0002-0759-4628
Karpitski Aliaksandr S., MD, Professor, Chief Physician, Brest Regional Hospital, Brest, Republic of Belarus.
https://orcid.org/0000-0001-6055-7220
Nazaruk Aleksandr M., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
https:/orcid.org/0000-0001-6700-9200
Malashchytski Yauheni A., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
https://orcid.org/0000-0003-0654-0879
Barysenka Maryia N., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
https:/orcid.org/0000-0003-1964-2276
Zhymaila Aliaksei S., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
https://orcid.org/0000-0003-4939-2132
Arlavets Andrei I., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
https://orcid.org/0000-0002-2205-5729
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