Factors Influencing on the Mortality in Patients With Obliterating Diseases of Lower Limb Arteries

Sumin, А. N.; Косова, М. А.; Medvedeva, Ju. D.; Щеглова, А. В.; Rajh, O. I.; Макаров, С. А.; Артамонова, Г. В.; Ls, Barbarash

doi:10.20996/1819-6446-2017-13-6-746-755

Cited by 6 publications

(1 citation statement)

References 22 publications

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“…Критическая ишемия конечности -это «край пропасти», на которой балансирует наш пациент. В данный тяжелый для больного момент существует отчетливая возможность обострения большинства сердечно-сосудистых заболеваний (острый инфаркт миокарда или нарушение мозгового кровообращения) [9][10][11], потеря конечности со всеми рисками смертельных осложнений в раннем и отдаленном послеоперационном периоде после высокой ампутации (пятилетняя смертность составляет не менее 70%) [16,18,19], высокий риск реоокклюзии успешной артериальной реконструкции в послеоперационном периоде [17,19]. В такой же зоне риска находятся ОЭГП с таким грозным осложнением как ЖКК [1,3,4,13,15].…”

Section: Discussionunclassified

Prevention of gastrointestinal bleeding in patients operated on the arteries of the lower extremities for critical ischemia

Полянцев

Frolov

Линченко

et al. 2023

jour

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The purpose of the study. To determine the frequency of occurrence and prevention measures of erosive and ulcerative lesions of the proximal gastrointestinal tract in patients operated for critical ischemia with a diagnosis of obliterating atherosclerosis of the arteries of the lower extremities. Materials and methods. The examination included patients with lower limb ischemia - III-IV stage of ischemia according to the Fontaine-Pokrovsky classification. The patients were divided into 2 groups: the control group, where treatment was carried out according to the recommendations: HP diagnosis (express test) was carried out only with an endoscopic picture of gastric ulcer and duodenal ulcer, as well as the main group, in which HP diagnosis was carried out totally with fibrogastroduodenoscopy and a standard three-component eradication scheme was prescribed for at least 14 days when bacterial contamination of the gastric mucosa was detected. Results. In all cases, endoscopic changes characteristic of gastritis were registered in patients of the first group. Of the eight patients (100%), two (25%) were diagnosed with single erosions in the distal parts of the stomach, one patient (12.5%) had atrophic gastritis, and the remaining 5 (62.5%) patients had hyperemia of the antral and prepiloric mucosa. In patients of the second group, there were no changes in FGDS in one patient (25%), foci of mucosal atrophy were diagnosed in two patients (50%), and single erosions in one (25%). Conclusion. Among patients with peripheral artery diseases accompanied by critical ischemia, by the time they seek specialized medical care, there are no healthy or close to such persons with unchanged mucous membrane of the proximal parts. In the high-risk groups for the occurrence of gastrointestinal bleeding, a complex effect on aggression factors is necessary

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Section: Discussionunclassified

Prevention of gastrointestinal bleeding in patients operated on the arteries of the lower extremities for critical ischemia

Полянцев

Frolov

Линченко

et al. 2023

jour

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Telemedicine technologies in improving the effectiveness of follow-up monitoring of patients with lower extremity peripheral artery disease during the COVID-19 pandemic

Макаров¹,

Smirnov²,

Danilchenko³

2023

Cardiovasc Ther Prev

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Aim. To evaluate the effectiveness of a novel approach to follow-up monitoring of patients with lower extremity peripheral artery disease (PAD) using telemedicine technologies.Material and methods. The study included 175 patients (mean age, 68,1±7,7 years). Two following groups of patients were formed: the main group (n=86), which used an optimized monitoring program using telemedicine techniques, and the control group (n=89), which assumed traditional monitoring by a cardiologist and a vascular surgeon. The mean follow-up period was 11,77±1,5 months. The optimized monitoring program included the implementation of audio communication with patients by an employee with a secondary medical education with an assessment of the current health status according to original unified questionnaire, with the definition of personalized management tactics. At the primary and final stages, the patient underwent an assessment of clinical and anamnestic data, mental and cognitive status, and compliance.Results. At the final stage, uncompensated hypertension was revealed in 36,0% and 49,4% (p=0,0001), smoking — in 30,6% and 42,9% (p=0,05) in the main and control group, respectively. In the main group, a greater pain-free walking distance was revealed — 625,8±395,3 m (control group — 443±417 m (p=0,013)). The average systolic blood pressure was 125,2±10,2 mm Hg and 138,8±15,8 mm Hg (p=0,0001) in the main and control group, respectively. In the control group, a greater number of patients with a high level of personal and situational anxiety were revealed (p=0,05). In the main group, a higher level of adherence to therapy was established at the final study stage (p=0,001).Conclusion. The optimized monitoring program for patients with limited mobility is effective and can be implemented in practical healthcare for patients with lower extremity PAD.

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Approaches to reduce the risk of progression of peripheral artery disease from the standpoint of a cardiologist

Сумин¹,

Медведева²,

Щеглова³

et al. 2021

Kompleks. probl. serdečno-sosud. zabol.

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Aim. To determine the factors contributing to the progression of peripheral artery diseases in patients receiving outpatient care within the 3-year follow-up.Methods. 585 patients with peripheral artery disease undergoing outpatient treatment in the period from 2010 to 2016 were recruited in a study. The follow-up period was three years. Patients were divided into two groups: Group 1 patients (n = 225) with a favorable course of peripheral atherosclerosis, and Group 2 patients (n = 303) with an unfavorable course of peripheral atherosclerosis. Patients were assigned to the groups based on their medical history (a decrease in pain-free walking distance within three years, amputation) and/or data of duplex scanning of the lower extremity arteries (significant progression of stenosis >20% over three years).Results. 87.1% of patients from Group 1 and 70.63% of patients from Group 2 visited cardiologists regularly within 3 years (p<0.0001). A total of 69.33% of patients from Group 1 and 61.39% of patients from Group 2 (p = 0.058) visited vascular surgeons within the follow-up period. Within three years, 47 (8.9%) patients achieved hard endpoints. Of them, 18 deaths, 14 myocardial infarctions, and 15 ischemic strokes. 25 patients underwent myocardial revascularization. Adherence to treatment within 3-years follow-up was significantly higher in patients with a favorable course (57.33% vs. 45.21%, p = 0.006). Multivariate logistic regression reported that adherence to treatment years (р=0.0009) and regular visits to cardiologists (p<0.001) significantly improved the 3-year prognosis in patients with peripheral artery disease.Conclusion. 57% of patients had an adverse course of peripheral atherosclerosis within 3-years follow-up. These results show that regular outpatient examinations of patients with peripheral atherosclerosis by cardiologists allow prescribing optimal drug therapy and reducing the risk of atherosclerosis progression.

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Factors Influencing on the Mortality in Patients With Obliterating Diseases of Lower Limb Arteries

Cited by 6 publications

References 22 publications

Prevention of gastrointestinal bleeding in patients operated on the arteries of the lower extremities for critical ischemia

Prevention of gastrointestinal bleeding in patients operated on the arteries of the lower extremities for critical ischemia

Telemedicine technologies in improving the effectiveness of follow-up monitoring of patients with lower extremity peripheral artery disease during the COVID-19 pandemic

Approaches to reduce the risk of progression of peripheral artery disease from the standpoint of a cardiologist

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