SURGICAL TREATMENT OF PATIENTS WITH CRITICAL LOWER LIMB ISCHEMIA AND CORONARY ARTERY DISEASE

Oktabr, 2025-Yil 58 SURGICAL TREATMENT OF PATIENTS WITH CRITICAL LOWER LIMB ISCHEMIA AND CORONARY ARTERY DISEASE Iriskulov Akbarjon Odilovich Republican Specialized Scientific and Practical Medical Center of Cardiology https://doi.org/10.5281/zenodo.17311089 Abstract. The majority of patients with critical lower limb ischemia (CLLI) also suffer from coronary artery disease (CAD). After reconstructive operations in the aorto-iliac region, the risks of myocardial infarction and mortality remain high. Therefore, the sequence of coronary and limb revascularization remains a pressing issue. Keywords: critical lower limb ischemia; coronary artery disease; bifurcation aortofemoral bypass; hybrid surgery. Materials and Methods. This study presents the outcomes of treatment in 131 patients with CLLI and CAD involving the aorto-iliac segment. All patients underwent lower limb revascularization as the first stage. Bifurcation aorto-femoral bypass (BAFB) was performed in 88 patients (67.2%), while 43 patients (32.8%) underwent hybrid reconstruction of the aorto-iliac segment, including open femoral artery reconstruction and endovascular iliac stenting. Critical ischemia was resolved in all patients. No deaths were recorded among patients who underwent hybrid procedures, whereas 1 patient (1.1%) died after BAFB. Results. After surgery, CLLI was eliminated in all patients (100%), as confirmed by disappearance of resting pain and an ankle–brachial index (ABI) increase above 0.4. In group 1, 1 patient (0.76%) developed acute myocardial infarction followed by death, and 5 patients (3.8%) developed acute coronary syndrome with ST-segment depression but without hemodynamic instability. In group 2, 4 patients (3.05%) developed acute coronary syndrome with ST-segment depression, but no deaths occurred. Conclusion. 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