DOI: https://doi.org/10.22263/2312-4156.2021.2.38
Yanushko V.A.1, Klimchuk I.P.2, Mshar S.V.3, Kordzakhia G.E.2, Rogovoy N.A.2
Short-term results of endovascular treatment for obliterating atherosclerosis of the lower extremities arteries in patients over 70 years of age
1Republican Research Center «Cardiology», Minsk, Republic of Belarus
2The 4th City Clinical Hospital named after N.E. Savchenko, Minsk, Republic of Belarus
3Brest Regional Clinical Hospital, Brest, Republic of Belarus
Vestnik VGMU. 2021;20(2):38-44.
Abstract.
Objectives. To analyze short-term results of endovascular treatment for obliterating atherosclerosis of the lower extremities arteries in patients over 70 years of age.
Material and methods. From 2015 to 2019, 75 lower limbs were revascularized in 72 patients. Their mean age was 74.7±4.51 years. There were 67 (93%) patients with ischemia of the 3rd – the 4th degree according to Fontaine-Pokrovsky classification. Revascularization of the iliac segment was performed in 35 (48.6%) patients, of the iliofemoral segment – in 5 (7%), the femoral-popliteal segment – in 24 (33.4%), the tibial segment – in 8 (11%) patients.
Results. Technical success was attained in 97.2% of cases. The limb preservation was achieved in 100% of cases. Thrombosis of the revascularized artery developed in 2 (2.7%) cases (it was repaired endovascularly). Two patients (2.77%) died of acute cardiac failure.
Conclusions. Our study has shown good early results of endovascular treatment for obliterating atherosclerosis of the lower limbs arteries in patients over 70 years of age. High amputations were avoided in 100% of cases. However, an assessment of long-term results is required.
Key words: atherosclerosis, angioplasty, stenting, revascularization, comorbidity.
References
1. Klaphake S, de Leur K, Mulder PG, Ho GH, de Groot HG, Veen EJ, et al. Mortality after major amputation in elderly patients with critical limb ischemia. Clin Interv Aging. 2017 Nov;12:1985-1992. doi: http://dx.doi.org/10.2147/CIA.S137570
2. Reinecke H, Unrath M, Freisinger E, Bunzemeier H, Meyborg M, Lüders F, et al. Peripheral arterial disease and critical limb ischaemia: still poor outcomes and lack of guideline adherence. Eur Heart J. 2015 Apr;36(15):932-8. doi: http://dx.doi.org/10.1093/eurheartj/ehv006
3. Savji N, Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, et al. Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects. J Am Coll Cardiol. 2013 Apr;61(16):1736-43. doi: http://dx.doi.org/10.1016/j.jacc.2013.01.054
4. Fowkes FGR, Aboyans V, Fowkes FJI, McDermott MM, Sampson UKA, Criqui MH. Peripheral artery disease: epidemiology and global perspectives. Nat Rev Cardiol. 2017 Mar;14(3):156-170. doi: http://dx.doi.org/10.1038/nrcardio.2016.179
5. Antipova EA. Demographic aging in the Republic of Belarus: spatial and temporal dynamics and regional trends in the context of sustainable development. Belorus Ekonom Zhurn. 2017;(4):129-46. (In Russ.)
6. United Nations, Department of Economic and Social Affairs, Population Division. World Population ageing 2019. Highlights. New York; 2019. 46 p.
7. Plaisance BR, Munir K, Share DA, Mansour MA, Fox JM, Bove PG, et al. Safety of Contemporary Percutaneous Peripheral Arterial Interventions in the Elderly. JACC Cardiovasc Interv. 2011 Jun;4(6):694-701. doi: http://dx.doi.org/10.1016/j.jcin.2011.03.012
8. Bradbury AW, Adam DJ, Bell J, Forbes JF, Fowkes FGR, Gillespie I, et al. Bypass versus angioplasty in severe ischemia of leg (BASIL) trial: analysis of amputation free and overall survival by treatment received. J Vasc Surg. 2010 May;51(5 Suppl):18S-31S. doi: http://dx.doi.org/10.1016/j.jvs.2010.01.074
9. Wiseman JT, Fernandes-Taylor S, Saha S, Havlena J, Rathouz PJ, Smith MA, et al. Endovascular Versus Open Revascularization for Peripheral Arterial Disease. Ann Surg. 2017 Feb;265(2):424-430. doi: http://dx.doi.org/10.1097/SLA.0000000000001676
Information about authors:
Yanushko V.A. – Doctor of Medical Sciences, professor, chief researcher of the Laboratory of Vascular Surgery, RSPC «Cardiology»;
Klimchuk I.P. – Candidate of Medical Sciences, vascular surgeon, head of the department of vascular surgery, the 4th City Clinical Hospital named after N.E. Savchenko;
Mshar S.V. – vascular surgeon of the angiographic room, Brest Regional Clinical Hospital;
Kordzakhia G.E. – vascular surgeon of the department of vascular surgery, the 4th City Clinical Hospital named after N.E. Savchenko;
Rogovoy N.A. – Candidate of Medical Sciences, vascular surgeon of the department of vascular surgery, the 4th City Clinical Hospital named after N.E. Savchenko.
Correspondence address: Republic of Belarus, 220089, Minsk, 110 R. Luxemburg str., the 4th City Clinical Hospital named after N.E. Savchenko. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Giorgi E. Kordzakhia.
