METHOD FOR SURGICAL THERAPY OF CRITICAL ISCHEMIA OF INFERIOR LIMBS IN CASE OF OCCLUDING LESIONS OF SHIN ARTERIES

摘要

FIELD: medicine, vascular surgery.;SUBSTANCE: one should perform femoral-tibial shunting with autovein being kept in its channel without isolation, form both proximal and distal anastomoses of the great subcutaneous vein with total femoral and posterior tibial arteries. Distal anastomosis should be applied in the lower third of patient's shin between posterior tibial artery and the great subcutaneous vein side-into-side. Moreover, one should leave the part of the great subcutaneous vein intact being distally against anastomosis to destroy the valves there and in median marginal vein, too, up to venous arch of foot. It is necessary to keep sources of the great subcutaneous vein permeable and not to tighten veins-perforants on foot. The method enables to perform reconstructive operations in case of complete occlusion of one of the shin's arteries, and, also, in case of proximal occlusions of both shin arteries at high peripheral vascular resistance that enables to exclude thrombotic complications.;EFFECT: higher efficiency of therapy.;1 ex