title: Surgical techniques in the treatment of multilevel arterial occlusive disease.
abstract: OBJECTIVE
  To report the surgical techniques for multilevel arterial lesions of the lower extremities and to evaluate the clinical outcomes. In patients with multilevel arterial disease, the treatment consisting of sequentially surgical intervention on the same vascular axis is one of the methods indicated in order to obtain an adequate inflow and outflow.
  
  
  METHODS
  we have performed a nonrandomized study during a 44-month period (January 2010-September 2013) in a number of 58 patients treated by classical revascularization techniques. All the patients included in the study have been post-surgically surveyed at well-established intervals (1, 3, 6, 9, 12, 24 and 36 months) by: clinical examination, laboratory tests, Duplex ultrasound, and, as needed, CT Angiography.
  
  
  RESULTS
  the 6 months primary patency in each studied group (corresponding to the years of 2010, 2011 and 2012) was 95%, 93.33%, and 91.3%, respectively; the 12 months primarypatency was 85%, 80%, and 82.6%, respectively. Clinical improvement has been noticed in44 patients (75.86%). There have been registered 14 amputations (24.13% of the cases): 7 majors (thigh and below the knee), representing 12.06% of the total number of cases and 7 minors (toe or transmetatarsal), representing 12.06% of the total number of cases. Limb salvage rate for the patients in stage III and IV Leriche-Fontaine was 85.10%.
  
  
  CONCLUSIONS
  the surgical techniques are a feasible option for the multilevel arterial disease, with
authors.affiliation: University of Medicine and Pharmacy Grigore T. Popa - Iaşi, Department of Surgery.
authors.forename: Livia Genoveva
authors.initials: LG
authors.lastname: Baroi
authors.forename: L
authors.initials: L
authors.lastname: Iacob
authors.forename: R F
authors.initials: RF
authors.lastname: Popa
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage / Q000379:methods / Q000706:statistics & numerical data; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014654:Vascular Patency