Поєднані ураження брахіоцефальних артерій та їх корекція у хворих з пізніми тромбозами аорто-стегнових протезів

Abstract

Progressive atherosclerosis саn lead to the development of brachiocephalic arterial pathology in remote period after aorto-femoral bypass surgery. Present work was aimed to establish the frequency and principles of management of concomitant lesions of brachiocephalic arteries in palients with late aorto-femoral graft thrombosis. Obligatory clinical and Duplex USG examination allowed to reveal concomitant brachiocephalic lesions in 58.2%, including carotid stenoses in 52.2%. Indications for simultaneous or staged carotid endarterectomy were established in 23.9% dependent оn symptoms, stenosis de gree and plaque morphology. No perioperative cerebral ischemic events were noted during secondary aorto-femoral reconstructions in these patients оп contrary to the group of historic control. Rest pain due to critical leg ischemia сап bе eliminated bу the means of epidural analgesia, what allowes to perform carotid surgery under !оса! anesthesia with аІІ its advantag