Surgical Treatment of Acute Thrombosis Arteries of Infrapopliteal Segment

Abstract

Aim of the study. Aim of the study was to analyze the outcomes of surgical treatment of acute thrombosis of the popliteal-tibial segment arteries with various etiological factors of its occurrence.
 The analysis of the surgical treatment of 40 patients with acute thrombosis of the popliteal-tibial segment arteries was carried out for the period from 2014 to 2020. Depending on the pathogenesis of acute thrombosis of the popliteal-tibial segment arteries, the patients were divided into three groups: Group 1 – 17 (42.5%) patients with acute arterial thrombosis of the popliteal-tibial segment caused by embolism or thrombosis in the background of stenotic-occlusive diseases of the lower extremitiesvessels; Group 2 – 15 (37.5%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of thromboangiitisobliterans of the lower extremities (Buerger's disease); Group 3 – 8 (20%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of popliteal artery aneurysm. During the follow-up period of 2 months, the incidence of rethrombosis and amputation of the lower limb in the patients of Group A was 5.9% and 5.9%, respectively. In Group B, the incidence of rethrombosis and amputation of the lower limb was 73.3% and 40.0%, respectively. In group C, the incidence of rethrombosis and amputation of the lower limb was 12.5% and 12.5%, respectively.
 Conclusions. In patients with acute arterial thrombosis of the popliteal-tibial segment in the background of embolism or stenotic-occlusive diseases, combined endovascular or hybrid surgical interventions showed better results compared to open thrombectomy, in which rethrombosis was diagnosed in 14.3% of cases. In patients with thromboangiitis obliterans of the lower extremities, regional catheter-directed thrombolysis showed better (p=0,04) results compared to open thrombectomy and endovascular interventions, in which rethrombosis was diagnosed in 90% and 100% of cases, respectively. In patients with popliteal artery aneurysm, open surgical interventions or regional catheter-directed thrombolysis showed better results compared to endovascular interventions, in which rethrombosis was diagnosed in 50% of cases.