Selection of Lower Limb Revascularization Methods in Multilevel Atherosclerotic Arterial Disease: A Review
https://doi.org/10.35401/2541-9897-2025-10-3-119-126
Abstract
This literature review systematizes current approaches to lower limb revascularization, including surgical techniques used in the treatment of critical limb ischemia in patients with multifocal atherosclerotic arterial disease. The study analyzes the criteria for selecting surgical interventions and compares the advantages and disadvantages of interventional treatment methods in patients at high risk of atherosclerotic complications.
About the Authors
T. Kh. Temerezov
North Caucasian State Academy
Russian Federation
Russian Federation
Marat B. Temrezov, Dr. Sci. (Med.)., Professor, Head of the Department of Hospital Surgery with Courses in Anesthesiology and Resuscitation
ulitsa Stavropolskaya 36, Cherkessk, Karachay-Cherkessia, 369001
M. B. Temrezov
North Caucasian State Academy
Russian Federation
Russian Federation
Taulan Kh. Temerezov, Assistant, Department of Hospital Surgery with Courses in Anesthesiology and Resuscitation
ulitsa Stavropolskaya 36, Cherkessk, Karachay-Cherkessia, 369001
A. U. Badakhov
North Caucasian State Academy
Russian Federation
Russian Federation
Aznaur U. Badakhov, Postgraduate Student, Department of Hospital Surgery with Courses in Anesthesiology and Resuscitation
ulitsa Stavropolskaya 36, Cherkessk, Karachay-Cherkessia, 369001
R. A. Dinaev
North Caucasian State Academy
Russian Federation
Russian Federation
Ramazan A. Dinaev, Assistant, Department of Hospital Surgery with Courses in Anesthesiology and Resuscitation
ulitsa Stavropolskaya 36, Cherkessk, Karachay-Cherkessia, 369001
References
1. Zakeryaev AB, Vinogradov RA, Sukhoruchkin PV, et al. Different methods of femoropopliteal bypass grafting with autologous vein: propensity score matching analysis. Pirogov Russian Journal of Surgery. 2022;(10):44-50. (In Russ.) https://doi.org/10.17116/hirurgia202210144
2. Zakeryaev A.B., Vinogradov R.А., Sukhoruchkin P.V., Butaev S.R., Bakhishev T.E., Derbilov A.I., Urakov E.R., Baryshev A.G., Porkhanov V.A. Long-term outcomes of a novel method of femoropopliteal bypass. Russian Journal of Cardiology. 2022;27(8):4843. (In Russ.) https://doi.org/10.15829/1560-4071-2022-4843
3. Zakeryaev AB, Vinogradov RA, Sukhoruchkin PV, Butaev SR. Femoropopliteal bypass surgery. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(3):272‑282. (In Russ.) https://doi.org/10.17116/kardio202316031272
4. Lekyan BG, Karapetyan NG, Chupin AV, Zotikov AE, Varava AB, Ushakov AA, et al. Long-term outcomes of two treatment strategies for critical limb ischemia combined with coronary artery disease. Kardiologicheskii vestnik. 2022;17(2):55. https://doi.org/10.17116/cardiobulletin20221702155
5. Arakelian VS. Amputation as an anticipated consequence of peripheral artery disease and ways to improve the prognosis of limb salvage. Angiology and vascular surgery. 2021;27(1):182. https://doi.org/10.33529/angio2021101
6. Pokrovsky AV, Kazakov YI, Lukin IB. Critical Ischemia of the Lower Limbs. Infrainguinal Lesions [monograph]. Tver, Russia: Publishing Center of Tver State University; 2018:225.
7. Arakelyan VS, Demidova OA, Sergeev SY. Present-Day Therapeutic Policy in Patients with Chronic Ischaemia of Lower Limbs: Trans-Atlantis Inter-Society Consensus. Angiology and vascular surgery. 2009;15(3):127-133
8. Vinogradov R.A., Zakeryaev A.B., Bakhishev T.E., Butaev S.R., Khangereev G.A., Sozaev A.A., Baryshev A.G., Porhanov V.A. Femoropopliteal Bypass Surgery for Total Calcification of the Iliofemoral Segment. Innovative Medicine of Kuban. 2024;(3):79-83. (In Russ.) https://doi.org/10.35401/2541-9897-2024-9-3-79-83
9. Gavrilenko AV, Al-Usef NN, Khaozhan E, et al. Comparing the results of endovascular interventions and bypass surgery in patients with chronic lower limb ischemia. Angiology and vascular surgery. 2022;28(1):154–162. https://doi.org/10.33029/1027-6661-2022-28-1-154-162
10. YuI Kazakov, IB Lukin, NYu Sokolova, OV Ivanova, DV Zhuk. Does an Attempt to Save a Limb Always Prolong the Patient’s Life? Angiology and vascular surgery. 2020;26(1):121-128. https://doi.org/10.33529/ANGIO2020125
11. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-S67. PMID: 17223489. https://doi.org/10.1016/j.jvs.2006.12.037
12. Mwipatayi BP, Ouriel K, Anwari T, et al. A systematic review of covered balloon-expandable stents for treating aortoiliac occlusive disease. J Vasc Surg. 2020;72(4):1473-1486.e2. PMID: 32360678. https://doi.org/10.1016/j.jvs.2020.01.084
13. Joh JH, Joo SH, Park HC. Simultaneous hybrid revascularization for symptomatic lower extremity arterial occlusive disease. Exp Ther Med. 2014;7(4):804-810. PMID: 24669236. PMCID: PMC3961109. https://doi.org/10.3892/etm.2014.1513
14. Gentile F, Lundberg G, Hultgren R. Outcome for Endovascular and Open Procedures in Infrapopliteal Lesions for Critical Limb Ischemia: Registry Based Single Center Study. Eur J Vasc Endovasc Surg. 2016;52(5):643-649. PMID: 27592734. https://doi.org/10.1016/j.ejvs.2016.07.013
15. Kreutzburg T, Peters F, Rieß HC, et al. Editor’s Choice - Comorbidity Patterns Among Patients with Peripheral Arterial Occlusive Disease in Germany: A Trend Analysis of Health Insurance Claims Data. Eur J Vasc Endovasc Surg. 2020;59(1):59-66. PMID: 31744786. https://doi.org/10.1016/j.ejvs.2019.08.006
16. Hunt BD, Popplewell MA, Davies H, et al. BAlloon versus Stenting in severe Ischaemia of the Leg-3 (BASIL-3): study protocol for a randomised controlled trial. Trials. 2017;18(1):224. PMID: 28526046. PMCID: PMC5438558. https://doi.org/10.1186/s13063-017-1968-615.
17. Lysenko ER, Burov AIu, Griaznov OG, Bushueva EV. Use of endovascular drug-coated devices in lesions of femoropopliteoltibial arteries. Angiology and vascular surgery. 2021;27(3):165-172. https://doi.org/10.33529/angiq2021305
18. Haider SN, Kavanagh EG, Forlee M, et al. Two-year outcome with preferential use of infrainguinal angioplasty for critical ischemia. J Vasc Surg. 2006;43(3):504-512. PMID: 16520164. https://doi.org/10.1016/j.jvs.2005.11.016
19. Katsanos K, Spiliopoulos S, Teichgräber U, et al. Editor’s Choice - Risk of Major Amputation Following Application of Paclitaxel Coated Balloons in the Lower Limb Arteries: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Eur J Vasc Endovasc Surg. 2022;63(1):60-71. PMID: 34326002. https://doi.org/10.1016/j.ejvs.2021.05.027
20. Pokrovsky AV, Golovyuk AL. Vascular surgery in the Russian Federation in 2018. Angiology and vascular surgery. 2018;25(2):1-40. (In Russ.)
21. Humbarger O, Siracuse JJ, Rybin D, et al. Broad variation in prosthetic conduit use for femoral-popliteal bypass is not justified on the basis of contemporary outcomes favoring autologous great saphenous vein. J Vasc Surg. 2019;70(5):1514-1523.e2. PMID: 31147137 https://doi.org/10.1016/j.jvs.2019.02.046
22. Peters R.J.G, Kok W.E.M, et al. Videodensitometric quantitative angiography after coronary balloon angioplasty, compared to edge-detection quantitative angiography and intracoronary ultrasound imaging. European Heart Journal. 2000;8(21):654–661. https://doi.org/10.1053/euhj.1999.1853
23. Pennywell DJ, Tan TW, Zhang WW. Optimal management of infrainguinal arterial occlusive disease. Vasc Health Risk Manag. 2014;10:599-608. PMID: 25368519. PMCID: PMC4216027. https://doi.org/10.2147/vhrm.s50779
24. Porter JM, Eidemiller LR, Dotter CT, Rösch J, Vetto RM. Combined arterial dilatation and femorofemoral bypass for limb salvage. Surg Gynecol Obstet. 1973;137(3):409-412. PMID: 4721511.
25. Adzhieva FI, Zyablova EI. The role of CT angiography in determining treatment strategy for lower limb arterial diseases. Innovative Medicine of Kuban. 2024;(4-1):28. (In Russ.)
26. Argyriou C, Georgakarakos E, Georgiadis GS, Antoniou GA, Schoretsanitis N, Lazarides M. Hybrid revascularization procedures in acute limb ischemia. Ann Vasc Surg. 2014;28(6):1456-1462. PMID: 24530573. https://doi.org/10.1016/j.avsg.2014.01.019
27. MS Kim, YS Joo, KH Park. Results of Simultaneous Hybrid Operation in Multi-level Arterial Occlusive Disease. J Korean Surg Soe. 2010;79(5):386-392. https://doi.org/10.4174/jkss.2010.79.5.386
28. Dosluoglu HH, Lall P, Cherr GS, Harris LM, Dryjski ML. Role of simple and complex hybrid revascularization procedures for symptomatic lower extremity occlusive disease. J Vasc Surg. 2010;51(6):1425-1435.e1. PMID: 20488323. https://doi.org/10.1016/j.jvs.2010.01.092
29. Brewster DC, Cambria RP, Darling RC, et al. Long-term results of combined iliac balloon angioplasty and distal surgical revascularization. Ann Surg. 1989;210(3):324-331. PMID: 2528334. PMCID: PMC1357996. https://doi.org/10.1097/00000658-198909000-00008
30. Hicks CW, Najafian A, Farber A, et al. Below-knee endovascular interventions have better outcomes compared to open bypass for patients with critical limb ischemia. Vasc Med. 2017;22(1):28-34. https://doi.org/10.1177/1358863x16676901
Review
For citations:
Temerezov T.Kh., Temrezov M.B., Badakhov A.U., Dinaev R.A. Selection of Lower Limb Revascularization Methods in Multilevel Atherosclerotic Arterial Disease: A Review. Innovative Medicine of Kuban. 2025;10(3):119-126. (In Russ.) https://doi.org/10.35401/2541-9897-2025-10-3-119-126
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