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Poliantsev AA, Frolov DV, Linchenko AM, Karpenko SN, Kosivtsov OA, Chernovolenko AA, Kaplunova EV. Prevention of erosive and ulcerative gastroduodenal bleeding in patients after endovascular surgery on the arteries of the lower extremities for critical ischemia. GREKOV'S BULLETIN OF SURGERY 2022. [DOI: 10.24884/0042-4625-2022-181-2-24-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The OBJECTIVE was to evaluate methods for the prevention of gastrointestinal bleeding in patients after endovascular surgery on the arteries of the lower extremities for critical ischemia.METHODS AND MATERIALS. The study included 188 patients treated in the vascular surgery department of A. A. Polyantsev General Surgery Clinic of Volgograd State Medical University for obliterating atherosclerosis of the arteries of the lower extremities in the period from 2017 through 2021.RESULTS. There was a relationship between the indicator that the patient indicated independently – the number of painkillers taken per day to reduce pain, and erosive and ulcerative lesions of the stomach and duodenum in both groups. The increasing number of operations with critical lower extremity ischemia (СLEI) and the expected decrease in the number of amputations indicates the increased capabilities of vascular and X-ray endovascular surgeons in preserving the extremity and ultimately the life of patients with decompensated forms of obliterating lesions of the extremities. This group of patients had a large number of perioperative complications from various organs and systems, including a high probability of gastrointestinal bleeding.CONCLUSION. An increased risk group for the occurrence of gastrointestinal bleeding (GIB): patients with repeated reconstructions, surgical corrections of complications or amputations at various levels, as well as taking anticoagulants in therapeutic dosage. Long-term routine prevention of acute erosive and ulcerative lesions of the stomach and duodenum, gastrointestinal bleeding with proton pump inhibitors is not acceptable for this group of patients. It is necessary to have a complex effect on the factors of aggression – the exclusion of the use of NSAIDs, total eradication.
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Fereydooni A, Zhou B, Xu Y, Deng Y, Dardik A, Ochoa Chaar CI. Rapid increase in hybrid surgery for the treatment of peripheral artery disease in the Vascular Quality Initiative database. J Vasc Surg 2020; 72:977-986.e1. [DOI: 10.1016/j.jvs.2019.11.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/18/2019] [Indexed: 12/26/2022]
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Mustapha JA, Anose BM, Martinsen BJ, Pliagas G, Ricotta J, Boyes CW, Lee MS, Saab F, Adams G. Lower extremity revascularization via endovascular and surgical approaches: A systematic review with emphasis on combined inflow and outflow revascularization. SAGE Open Med 2020; 8:2050312120929239. [PMID: 32551113 PMCID: PMC7278295 DOI: 10.1177/2050312120929239] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 05/03/2020] [Indexed: 11/15/2022] Open
Abstract
This review is intended to help clinicians and patients understand the present state of peripheral artery disease, appreciate the progression and presentation of critical limb ischemia/chronic limb-threatening ischemia, and make informed decisions regarding inflow and outflow endovascular revascularization and surgical treatment options within the context of current debates in the medical community. A controlled literature search was performed to obtain research on outcomes of critical limb ischemia patients undergoing complete leg revascularization for peripheral artery disease inflow and outflow disease. Data for this review were identified by queries of medical and life science databases, expert referral, and references from relevant papers published between 1997 and 2019, resulting in 48 articles. The literature review herein indicates that endovascular revascularization-including ballooning, stenting, and atherectomy-is an effective peripheral artery disease therapy for both above the knee and below the knee disease, and can safely and effectively treat both inflow and outflow disease. As such, it plays a leading role in the therapy of lower extremity artery disease.
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Affiliation(s)
| | - Bynthia M Anose
- Department of Clinical and Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, MN, USA
| | - Brad J Martinsen
- Department of Clinical and Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, MN, USA
| | - George Pliagas
- Vascular Division, Premier Surgical Associates, Knoxville, TN, USA
| | - Joseph Ricotta
- Tenet Florida Cardiovascular Care, Delray Beach, FL, USA
| | - Christopher W Boyes
- Carolinas Medical Center and Sanger Heart & Vascular Institute, Vascular Surgery, Charlotte, NC, USA
| | | | - Fadi Saab
- Advanced Cardiac & Vascular Centers, Grand Rapids, MI, USA
| | - George Adams
- North Carolina Heart and Vascular, Rex Hospital, UNC School of Medicine, Raleigh, NC, USA
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Hybrid Surgery in Lower Limb Revascularization: A Real-World Experience from a Single Center. Ann Vasc Surg 2019; 60:355-363. [DOI: 10.1016/j.avsg.2019.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/06/2019] [Accepted: 03/11/2019] [Indexed: 01/22/2023]
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Jorshery SD, Skrip L, Sarac T, Ochoa Chaar CI. Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass. J Vasc Surg 2018; 68:1447-1454.e5. [DOI: 10.1016/j.jvs.2018.01.058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 01/30/2018] [Indexed: 01/22/2023]
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Li X, Partovi S. End-organ dysfunction in peripheral arterial disease - it is all about the skeletal muscle microvasculature. VASA 2018; 47:255-257. [PMID: 29912673 DOI: 10.1024/0301-1526/a000717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Xin Li
- 1 Case Western Reserve University School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sasan Partovi
- 2 Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Lee SC, Joh JH, Chang JH, Kim HK, Kim JY, Park K, Hong KC, Byun SJ, Lee TS, Jung HJ, Lee SS. Hybrid treatment of multilevel revascularization in patients with peripheral arterial disease – a multi-centre study in Korea. VASA 2018; 47:235-241. [DOI: 10.1024/0301-1526/a000694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. Background: Endovascular treatment is an alternative first-line management for peripheral artery disease (PAD). Hybrid treatment (HT) is defined as a combined treatment for patients with PAD using endovascular and open surgery, simultaneously performed in an operating room. The results of HT are reportedly good for multilevel revascularization (MR) in patients with chronic limb ischaemia, and even in older high-risk patients. The goal of this study was to examine the clinical and haemodynamic outcomes of HT in patients who need MR. Patients and methods: Nine university hospitals in Korea participated in this multicentre study. A total of 134 patients with multilevel PAD underwent HT and MR. Patients were enrolled from July 2014 to June 2015 and were followed for 18 months. Results: The mean age of the patients was 68.8 ± 9.93 years and 88.1 % were men. Patients with Rutherford category 2 to 3 and 4 to 6 comprised 59.0 % and 42.0 % of the group, respectively. The technical success rate was 100 %. The primary patency rates at 12 and 18 months were 77.6 % and 63.9 %, respectively. The primary-assisted patency rates at 12 and 18 months were both 90.0 %. The pre-operative mean ankle brachial index (0.43 ± 0.23) increased to 0.87 ± 0.23 at six months post-operatively (t-test, p < 0.05). The amputation free survival rate was 97.1 %. Conclusions: Although outcomes of multilevel PAD are reportedly poor when endovascular treatment alone is used, we have shown that HT is a feasible alternative modality for patients with multilevel PAD, with satisfactory amputation-free survival and freedom from re-intervention rates.
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Affiliation(s)
- Soon Cheon Lee
- Department of Surgery, Gwangyang Sarang Hospital, Gwangyang, Republic of Korea
| | - Jin Hyun Joh
- Department of Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Jeong-Hwan Chang
- Department of Surgery, Chosun University College of Medicine and Cheondam Medical Center, Gwangju, Republic of Korea
| | - Hyung-Kee Kim
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jang Yong Kim
- Department of Surgery, Catholic University College of Medicine, Republic of Korea
| | - KiHyuk Park
- Department of Surgery, Daegu Catholic University College of Medicine, Daegu, Republic of Korea
| | - Ki Chun Hong
- Department of Surgery, Inha University College of Medicine, Incheon, Republic of Korea
| | - Seung Jae Byun
- Department of Surgery, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Tae Seung Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyuk Jae Jung
- Research Institute for Convergence of Biomedical Science and Technology, Division of Vascular and EndoVascular Surgery, Department of Surgery, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Sang Su Lee
- Research Institute for Convergence of Biomedical Science and Technology, Division of Vascular and EndoVascular Surgery, Department of Surgery, Pusan National University School of Medicine, Yangsan, Republic of Korea
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Response: "Percutaneous Vascular Interventions Versus Bypass Surgeries in Patients With Critical Limb Ischemia". Ann Surg 2017; 268:e70-e71. [PMID: 29227345 DOI: 10.1097/sla.0000000000002625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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