Coronary artery bypass grafting on a beating heart in combination with carotid endarterectomy in patients with multifocal atherosclerosis associated type 2 diabetes mellitus

Usenko, О. Yu.; Gabriyelyan, A. V.; Beleiovych, V.; Ratushniuk, A. V.; Chaikovska, S.; Bura, I. B.

doi:10.30978/cees-2020-4-14

Cited by 1 publication

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“…населення. Після ампутації значно підвищується ризик серйозних серцевосудинних ускладнень (інфаркт міокарда, ішемічний інсульт тощо), стрімко зростає летальність [4,5].…”

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Auto-venous femoral-popliteal bypass in patients with critical lower extremity ischemia and coronary heart disease associated with diabetes melitus

Nikul'nikov¹,

Ratushniuk²,

Liksunov³

et al. 2021

CE&ES

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Аim — to improve the results of treatment of patients with atherosclerotic lesions of the arteries of femoral-popliteal segment, who underwent autovenous femoral-popliteal bypassgrafting.Materials and methods. During the period of years 2018 to 2021, 34 patients with critical ischemia of the lower extremities underwent autovenous shunting with a reversed great saphenous vein with treatment of the inner surface of the vein with a solution of cytostatics (paclitaxel). Besides, the treatment was analysed in two control groups, who underwent autovenous reverse vein shunting (30 patients) and autovenous in-situ shunting (33 patients). The follow-up periods lasted for 24 months. The evaluation criteria included the cases of shunt thrombosis, shunt stenosis, mortality, serious ischemic events — acute lower extremity ischemia, myocardial infarction, ischemic stroke, cases of high amputations of the lower extremities.Results. In the postoperative period, no deaths were observed; absence of complicationswas registered in 96 (98 %) patients. In the main group, the frequency of shunt thrombosis was 5 (14.7 %), hemodynamically significant restenosis was diagnosed in 6 patients (17.6 %), acute myocardial infarction in 1 patient (2.9 %). In the comparison group, 11 cases of autovenous shunt thrombosis were defined.Conclusions. Our clinical experience showed promising short- and medium-term results. The chosen surgical approach and topical application of cytostatic drugs enabled to achieve long-term patency of venous shunt, which is of particular importance for patients with diabetes mellitus.

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