REPEATED MULTILEVEL REVASCULARIZATION PROCEDURES ON THE AORTA AND MAJOR ARTERIES OF THE LOWER EXTREMITIES

This article presents the results of the examination and treatment of 108 patients admitted with recurrent chronic critical lower limb ischemia that developed at various intervals after primary reconstructive vascular surgery. Detailed evaluation revealed that in 40.7% of cases there was an objective cause for the development of postopera­tive complications and recurrent critical ischemia. All patients underwent repeat surgery based on the identified causes, and preventive measures were implemented to reduce the risk of further complications. Favorable outcomes were achieved, with restoration of the main arterial blood flow in 78.7% of cases.

Optimal approaches to repeat reconstructive procedures were determined according to the cause of recur­rent chronic critical limb ischemia. Indications for and methods of combined treatment of postoperative complications following primary reconstructive procedures were also developed. The surgical procedures included resection of an abdominal aortic aneurysm, aortobifemoral bypass grafting, multilevel lower limb bypass surgery, femorotibial in situ bypass grafting, thrombectomy, autogenous vein patch angioplasty of vascular anastomoses, and profundoplasty.