title: [Surgical policy in patients aged 70 years and over presenting with grade iv chronic ischaemia of lower limbs].
abstract: The present work deals with a currently important problem concerning surgical decision-making in treatment of lower-limb critical ischaemia in elderly and aged people. A total of fifty-three 70-and-more-year-old patients presenting with an ulcerative-and-necrotic lesion of soft tissue of the crus and foot underwent treatment at Hospital of War Veterans No?2. They were subdivided into two groups depending on the level (height) of occlusion, and each of the groups was further subdivided into subgroups of patients subjected to the classical for the given localization of the lesion shunting operations, to compare the latter with less traumatic but at the same time less effective minor and non-anatomical reconstructions. Statistical analysis of the therapeutic outcomes in the immediate and remote (2-year) follow-up period revealed that comparing the iliac-femoral and cross femoro-femoral reconstructions, the best results were obtained after extra-anatomical operations. While comparing the femoropopliteal bypasses and profundoplasty showed that the obtained therapeutic outcomes were similar with certain advantage of the routinely performed shmting reconstructions. Based on the obtained findings, a conclusion was made on efficacy the principle of not maximal but sufficient revascularisation of lower-limb tissues owing to a predominant use of minor and non-anatomical reconstructions.
authors.forename: N B
authors.initials: NB
authors.lastname: Ismailov
authors.forename: A V
authors.initials: AV
authors.lastname: Vesnin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006291:Health Policy; D006801:Humans; D007511:Ischemia / Q000503:physiopathology* / Q000601:surgery*; D035002:Lower Extremity / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*