Possibilities of Endovasal Interventions in Case of Critical Ischemia in Patients with Metabolic Syndrome

Petr Puzdryak  ¹, Anastasia Artemova ¹, Nikolay Lukianchikov  ², Michael Ivanov  ¹

¹ Department of General Surgery of North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia; ² I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation, Moscow, Russia;

Date, time and location: 2018.05.26 08:30, Exhibition area, 1st Floor. Zone – A

Abstract

The aim of this study is to compare the use of open and endovascular interventions about CLI in patients with PAD against metabolic syndrome (MS).

Materials and methods: treatment results of 73 patients with PAD suffering from critical ischemia were studied. The feature of analyzed groups of patients is the prevalence of violations of carbohydrate metabolism. Patients were divided into two groups: 48 patients (mean age 69.5 ± 9.2 years) constituted the main group, he underwent endovascular interventions; 25 patients (mean age 64.8 ± 9.2 years) made up a control group - they performed open operations. The groups are comparable in features of atherosclerotic lesion (TASC II). The size of the bed-day, the duration of the interventions, the oxygenation of tissues before surgery and 30 days after the operation, the dynamics of trophic disorders, the development of complications were analyzed. 

RESULTS: Among patients in the main group, trophic changes in the tissues against the background of MS components were significantly more frequent. The duration of hospitalization of patients in the main group was less than in patients with open surgery (p <0.05). The duration of operative intervention in the main group (84.5 ± 49.0 minutes) was significantly less than in the control group (211.1 ± 103.4 minutes, p <0.05). Intraoperative blood loss in the control group was 542 ± 131.1 ml (p <0.05). The dynamics of elimination of trophic disorders is more pronounced in patients of the main group (p <0.05). In patients of the main group in the postoperative period, the development of the so-called. "Major" complications: thrombosis of the operated segment, bleeding, infectious complications (2 v/s 4, p <0,05).

Conclusions: In the treatment of patients with MS suffering from CLI (including the presence of trophic changes), endovascular interventions can be a method of choice.