Results of X-Ray Endovascular Interventions on Infrainguinal Arteries in the Treatment of Chronic Lower Limb Ischemia of Atherosclerotic Genesis

Abstract

Background. X-ray endovascular arterial interventions become the operation of choice for atherosclerotic lesions of the infrainguinal arteries. The purpose of the study. To perform a comprehensive retrospective analysis of the outcomes of infrainguinal balloon angioplasty and stenting in the treatment of chronic lower limb ischemia of atherosclerotic genesis, depending on the initial stage of lower extremities chronic arterial insufficiency, the age of patients, the type of infrainguinal artery lesion according to TASC II, the presence of diabetes mellitus. Material and methods. The study included 85 patients with chronic arterial insufficiency of the lower extremities who underwent X-ray endovascular interventions on the infrainguinal arteries in 2015. Results. By the end of the 7-year follow-up period, the lower limb in healthy patients was preserved in 50.6% cases, but this indicator among the patients who did not undergo repeated X-ray endovascular interventions and open arterial operations was 28.2%. The preservation of the lower limb in patients with lower extremities chronic arterial insufficiency at the initial 2b stage was 42.9%, at stage 3 – 30%, at stage 4 – 11.1%. In patients of the middle, elderly and senile age, X-ray endovascular surgery was effective in 23.1%, 24.4%, 41.2% cases. The effectiveness of endovascular interventions in patients with the TASC II A, B, C and D atherosclerotic artery lesions was 46.2%, 27.3%, 16.6%, 10.5%. After 7 years the lower limb was preserved in 7.7% and 31.9% of the patients with and without diabetes mellitus, the frequency of repeated X-ray endovascular interventions was 2.7% and 23.1%, and survival rate was 38.5% and 68.1% correspondingly. Conclusions. The outcomes of X-ray endovascular interventions in patients with infrainguinal arterial lesion depend on the stage of the lower extremities chronic arterial insufficiency, the age of patients, the TASC II type of the infrainguinal arteries damage, the presence of diabetes mellitus.