[Certain alternative solutions in surgical management of patients with conjunctive atherosclerotic lesions of the vascular system].
The author describes herein the first experience gained in performing simultaneous operations in a total of 48 patients presenting with conjunctive lesions of several arterial beds. All the variants of the combined lesions were subdivided in six groups: group I - the brachiocephalic and coronary beds (8 cases), group II - the brachiocephalic bed and aortoiliac zone (11 cases), group III - the coronary bed and aortoiliac zone (6 cases), group IV - the brachiocephalic, coronary beds and aortoiliac zone, group V - the visceral branches of the abdominal aorta and aortoiliac zone (12 cases), group VI - the coronary, brachiocephalic beds, visceral branches and aortoiliac zones (4 cases). Each group of patients was subjected to single-stage revascularization procedures simultaneously performed by several teams of surgeons. Within the structure of the single-stagi was used the author-patented method of aortofemoral bifurcation bypassing from access in patients from Groups II, III, and IV - 24 cases. Clinical examples are presented successful single-stage interventions with a detailed description of the stagewise structure simultaneous operations. Resulting from surgical management of 48 multifocal functionally significant lesions of arteries in various vascular beds, mortality rate following simultaneous revascularization procedures amounted to 4.2 % (with only two patients having died), with 8 (16.7%) patients having developed postoperative complications.
First Regional Clinical Hospital, Ekaterinburg, Russia.
B V
BV
Fadin
D000368:Aged; D001807:Blood Vessel Prosthesis; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D023921:Coronary Stenosis / Q000601:surgery; D004691:Endarterectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014656:Vascular Surgical Procedures / Q000379:methods*