SURGICAL TREATMENT OF ATHEROSCLEROTIC LESION OF ILIAC ARTERIES BY METHOD OF LOOP ENDARTERECTOMY

Background: loop endarterectomy (LEA) is one of the low-traumatic methods of modern treatment of arteries of the lower extremities atherosclerosis.
Objective: determining the advantages and disadvantages of loop endarterectomy of iliac arteries for successful implementation as a component of hybrid technology.
Materials and methods: the study was carried the results of treatment of 131 patients with obliterating atherosclerosis of lower limb arteries, with a preferential defeat of the iliac arteries. All patients underwent unilateral or bilateral LEA. In the early and late (5-7 years) postoperative periods all the patients were studied using a questionnaire survey and ultrasonic angioscanning, 23 patients underwent aorto-angiography, 68 – MSCT-scan.
Results: 107 (81,3%) cases the intervention was released only from the femoral access. Additional access to the retroperitoneal space required when performing a 24 (18,3%) operations. Specifi c to LEA complications was the casting areas of the plaque in the artery, other lower extremities, pronounced calcifi cation with lesion of all layers of the vascular wall hypoplasia, tortuosity or aneurysmal extension to the iliac arteries, high occlusion of the abdominal aorta. In these patients, shunting by synthetic prosthesis is the intervention of choice.
In the early postoperative period occurred thrombosis 5 (3,8%), subjected to loop endarterectomy iliac arteries.
Postoperative hospital day was 8+-2 days. Five-year survival after LEA is 77.1%.
Conclusions:
1) the study showed that LEA is promising, and may be a priority intervention on the iliac arteries.
2) the remote results of patency of the iliac arteries after LEA signifi cantly higher than in synthetic grafts that are installed in the aorto-femoral position.
3) the rejection of the use of synthetic substitutes or their use to a minimum (only as a patch) signifi cantly reduces the risk of infectious complications.

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