Treatment of Thrombotic Complications of Surgical Infrainguinal
Revascularizations
Šeliga P.1, Vaško J.1, Kováč P.1, Šimko M.2
1 Oddelenie cievnej chirurgie FNsP Prešov, Slovenská republika, primár: MUDr. J. Vaško 2 Oddelenie rádiodiagnostiky FNsP Prešov, Slovenská republika, primár: MUDr. M. Šimko |
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Summary:
Aim: Authors in the work analyse the patients hospitalized with thrombosis of the surgical infrainguinal reconstruction. They
evaluate the causes of reconstructions occlusions, therapeutic options in the treatment and their experiences with treatment of these
patients.
Method: It is the retrospective analysis of the patients hospitalized during years 2001–2006 at the Department of Vascular Surgery
of the Teaching Hospital J. A. Reimana in Prešov with thrombosis of the surgical infrainguinal reconstruction. During the study
period 723 surgical infrainguinal revascularization procedures were performed. The basic therapeutic approach in the care of these
patients is anticoagulation and digital subtraction angiography, then they decide between percutaneous endovascular treatment, surgical
thrombectomy, reoperation with implantation of the new reconstruction or conservative treatment. In the phase of irreversible
ischemia high amputation is indicated.
Results: Thrombosis of the reconstruction was occured in 109 subjects (15.8%). Prothesis was thrombosed in 71 subjects (65.14%),
vein in 38 subjects (34.86%). Percutaneous endovascular treatment was indicated in 3 subjects (2.8%), surgical thrombectomy with
correction of the stenosis in 23 subjects (21.1%), reoperation with implantation of the new reconstruction in 53 subjects (48.6%), conservative
approach in 21 subjects (19.3%), high amputation in 9 subjects (8.2%). The secondary patency after 12 months according
to the life table method analysis after percutaneous endovascular treatment was 75%, after surgical thrombectomy of the graft with
correction of stenosis 37% and after reoperation with implantation of the new reconstruction 72%.
Conclusion: Authors believe that the best treatment in the care of the patients with thrombosis of the surgical infrainguinal reconstruction
and critical limb ischemia is implantation of the new secondary reconstruction with autologous vein.
Key words:
infrainguinal bypass – graft occlusion – risk factors for graft occlusion
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