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SURGICAL TREATMENT OF PATIENTS WITH CRITICAL LOWER LIMB
ISCHEMIA AND CORONARY ARTERY DISEASE
I iskulo Akba jon Odilo ich
Republican Specialized Scien i ic and P ac ical Medical Cen e o Ca diology
h ps://doi.o g/10.5281/zenodo.17311089
Abs ac . The majo i y o pa ien s wi h c i ical lowe limb ischemia (CLLI) also su e om
co ona y a e y disease (CAD). A e econs uc i e ope a ions in he ao o-iliac egion, he isks
o myoca dial in a c ion and mo ali y emain high. The e o e, he sequence o co ona y and limb
e ascula iza ion emains a p essing issue.
Keywo ds: c i ical lowe limb ischemia; co ona y a e y disease; bi u ca ion ao o-
emo al bypass; hyb id su ge y.
Ma e ials and Me hods. This s udy p esen s he ou comes o ea men in 131 pa ien s
wi h CLLI and CAD in ol ing he ao o-iliac segmen . All pa ien s unde wen lowe limb
e ascula iza ion as he i s s age. Bi u ca ion ao o- emo al bypass (BAFB) was pe o med in 88
pa ien s (67.2%), while 43 pa ien s (32.8%) unde wen hyb id econs uc ion o he ao o-iliac
segmen , including open emo al a e y econs uc ion and endo ascula iliac s en ing. C i ical
ischemia was esol ed in all pa ien s. No dea hs we e eco ded among pa ien s who unde wen
hyb id p ocedu es, whe eas 1 pa ien (1.1%) died a e BAFB.
Resul s. A e su ge y, CLLI was elimina ed in all pa ien s (100%), as con i med by
disappea ance o es ing pain and an ankle–b achial index (ABI) inc ease abo e 0.4. In g oup 1, 1
pa ien (0.76%) de eloped acu e myoca dial in a c ion ollowed by dea h, and 5 pa ien s (3.8%)
de eloped acu e co ona y synd ome wi h ST-segmen dep ession bu wi hou hemodynamic
ins abili y. In g oup 2, 4 pa ien s (3.05%) de eloped acu e co ona y synd ome wi h ST-segmen
dep ession, bu no dea hs occu ed.
Conclusion. In pa ien s wi h concomi an CLLI and CAD, he adi ional s aged app oach
is associa ed wi h high isks. Ou indings indica e ha hyb id su ge y educes su gical auma,
while a leas 7 days o p eope a i e p epa a ion imp o es ca diac s abili y. Op imal managemen
should include p eope a i e p epa a ion, hyb id su gical app oaches, and an indi idualized
assessmen o isks.
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