Authors
Chizhova K.A., Puzdryak P.D., Ivanov M.A., Kasimova A.M.
NWSMU named after I. I. Mechnikov, St. Petersburg
Abstract
Backgraund. Choosing the optimal strategy for multilevel peripheral arterial disease (MPAD) is not easy.
The Aim of this study was to find an optimal combination of surgical and conservative treatment in patients with MPAD.
Materials and methods. The work was based on observations of 184 patients cases who underwent open surgery (OS-90 people) and hybrid interventions (HI – 94 people). An individual rehabilitation program was advised after reconstruction. The immediate results of operations and the long-term consequences were studied.
Results. The use of rehabilitation measures showed positive effect on walking distance and the limb salvage in patients during three years of follow-up.
Conclusion. Hybrid interventions for multilevel peripheral arterial disease are most justified with subsequent choice of an individual rehabilitation program and the use of training exercises.
Keywords: peripheral arterial disease, vascular reconstruction, rehabilitation.
References
1. Grandjean A, Iglesias K, Dubuis C, et al. Surgical and endovascular hybrid approach in peripheral arterial disease of the lower limbs. Vasa. 2016; 45(5): 417-422. doi:10.1024/0301-1526/a000561.
2. Zhou M, Huang D, Liu C, et al. Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease. Clin Interv Aging. 2014; 9: 1595-1603. Published 2014 Sep 22. doi:10.2147/CIA.S66860.
3. Glushkov NI, Ivanov MA, Apresyan AY, et al. Are hybrid technologies appropriate for revascularization of aortoiliac-femoral segment? Khirurgiia. 2020; (8): 49-54. doi: 10.17116/hirurgia202008149.
4. McQuade K, Gable D, Hohman S, et al. Randomized comparison of ePTFE/nitinol self-expanding stent graft vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral artery occlusive disease. J Vasc Surg. 2009; 49(1): 109-116. doi:10.1016/j.jvs.2008.08.041.
5. Jung HJ, Lee SC, Kim KY, et al.Simultaneous Hybrid Operation Common Femoral Endarterectomy and Endovascular Treatment in Multilevel Peripheral Arterial Disease with Critical Limb Ischemia. Indian J Surg. 2018; 80(2): 140-145. doi:10.1007/s12262-016-1570-2.
6. Lee SC, Joh JH, Chang JH, et al. Hybrid treatment of multilevel revascularization in patients with peripheral arterial disease — a multi-centre study in Korea. Vasa. 2018; 47(3): 235-241. doi:10.1024/0301-1526/a000694.
7. Parvar SL, Ngo L, Dawson J, et al. Long-term outcomes following endovascular and surgical revascularization for peripheral artery disease: a propensity score-matched analysis. Eur Heart J. 2021. doi: 10.1093/eurheartj/ehab116.
8. Sami F, Ranka S, Lippmann M, et al. Cardiac rehabilitation in patients with peripheral arterial disease after revascularization. Vascular. 2020: 1708538120945530. doi: 10.1177/1708538120945530.
