[The choice of the revascularization method in the patients with critical ischemia of the lower extremities].

Immediate and remote results of surgical treatment of 407 patients, suffering the lower extremities tissues critical ischemia, were analyzed. In 223 patients (the first group) endovascular revascularization was performed, in 165 (the second group)--the open-access reconstructive operations, in 31 (the third group)--the combined or hybrid interventions. The immediate technical success of operations in all this groups was equal and up to 90%. The lower extremities high amputations and complications rate is trustworthy bigger after operative interventions, then after endovascular. The remote results, including the lower extremities preservation rate and survival indices, did not differ trustworthy in the groups. The reoperations rate in remote period for critical ischemia of the lower extremities recurrences is significantly bigger after endovascular interventions performance. Thus, endovascular and the open-access surgical procedures are equally effective in patients, suffering critical ischemia of the lower extremities, but, choosing the revascularization method, it is necessary to take into account the affection localization and spread, the certain venous conduit presence, as well as the risk and expected span of life.

[Multidisciplinary approach to the treatment of patients with diabetic foot].

Diabetic foot (DF) is considered now the main cause of amputations of lower limbs. The analysis of the results of 266 percutaneous endovascular interventions (EV) performed during 2008-2012 in 245 patients with ischemic and neuroishemic DF was carried out. 76% of the patients underwent percutaneous balloon angioplasty (PBA), 24%--PBA + stenting. 91% of EV were technically successful. In 95% of the patients who achieved recovery of the main flow in the occluded arterial segment, clinical improvement was observed in the form of disappearance of the pain and start of the healing of ulcer-necrotic lesions of the foot. The main causes of technical failure (9%) were impossibility to pass through long calcified occlusions of infrainguinal arteries. The complication rate was 10.5%, major amputation--5.2%, mortality--0.8%. Long-term results were shown by the combined rate of amputation-free survival after 1, 3 and 5 years follow-up which made up respectively, 86%, 70% and 43%. EV is an effective treatment for patients with DF and an integrated multidisciplinary approach to achieve high limb salvage rates in the long-term period.