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SURGICAL TREATMENT STRATEGIES IN PATIENTS WITH CRITICAL LIMB
ISCHEMIA COMBINED WITH ISCHEMIC HEART 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.17311070
In oduc ion:
C i ical limb ischemia (CLI) is a se e e mani es a ion o pe iphe al a e ial disease, o en
associa ed wi h ischemic hea disease (IHD). Mo ali y and mo bidi y emain high due o he
sys emic na u e o a he oscle osis and pe iope a i e ca diac complica ions. Op imizing ea men
s a egies in his g oup emains a clinical challenge.
Ma e ials and Me hods:
Analysis o clinical da a and published s udies was pe o med o e alua e ou comes o
di e en e ascula iza ion app oaches in CLI pa ien s wi h coexis ing IHD. Pa icula a en ion
was gi en o he ole o hyb id ope a ions, ou ine co ona y e alua ion, and pe iope a i e
op imiza ion.
Resul s:
The p e alence o IHD among CLI pa ien s eaches 60–80%, and ca dio ascula dea h is
he leading cause o mo ali y, accoun ing o nea ly hal o all dea hs. Co ona y angiog aphy
be o e pe iphe al e ascula iza ion equen ly e eals signi ican co ona y s enoses, indica ing he
need o combined managemen . S udies demons a e ha s aged o hyb id s a egies, in eg a ing
open econs uc ion o emo al a e ies wi h endo ascula iliac s en ing, educe ope a i e auma
and pe iope a i e ca diac e en s. In ou analysis, all pa ien s achie ed elie o CLI, con i med by
pain eg ession and inc eased ankle-b achial index. In he bi u ca ion ao o- emo al bypass g oup,
one pa ien de eloped myoca dial in a c ion wi h subsequen enal ailu e, esul ing in dea h,
while se e al o he s expe ienced non- a al co ona y synd omes. In he hyb id g oup, acu e
co ona y synd omes occu ed bu we e managed conse a i ely wi hou a ali ies. P eope a i e
he apy including aspi in, s a ins, and be a-blocke s o a leas se en days con ibu ed o
pe iope a i e s abili y.
Conclusion:
CLI pa ien s wi h concomi an IHD emain a high su gical isk. Hyb id p ocedu es and
a ge ed p eope a i e p epa a ion signi ican ly educe complica ions. Mul idisciplina y app oaches
a e essen ial o imp o e su i al and long- e m ou comes.
Keywo ds: c i ical limb ischemia; ischemic hea disease; ao o- emo al bypass; hyb id
su ge y; e ascula iza ion; pe iope a i e complica ions.
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