[Immediate results of combined treatment of patients with chronic lower limb ischemia and concomitant coronary artery disease].

The incidence of lower-extremity arterial disease is growing year after year. According to the world literature data, progression of the disease leads to the development of major adverse cardiovascular events during both in-hospital and remote periods, to critical ischaemia of lower limbs, as well as to amputations. The primary purpose of treatment of chronic lower limb ischemia is not only to save the lower extremities but also to reduce the cardiovascular risk in this patient cohort. Our study was undertaken to analyse the efficacy of various strategies of treatment of patients with stage IIB chronic lower-limb ischemia combined with coronary artery disease. It included a total of 87 patients. Depending on the therapeutic policy chosen, they were divided into two groups: Group 1 consisted of 41 (47.1%) patients undergoing staged roentgenendovascular treatment (percutaneous coronary intervention, stenting and angioplasty of lower-limb arteries) and Group 2 comprised 46 (52.9%) patients subjected to staged combined treatment (percutaneous coronary intervention and open surgery of lower-limb arteries). The purpose of the present study was to examine the in-hospital outcomes of combined treatment: percutaneous coronary intervention and open surgical operations on arteries of lower limbs in patients with chronic lower-limb ischemia and accompanying coronary artery disease. The forty-six Group 2 patients endured a total of 111 operations: 53 primary open operations on lower-limb arteries and 58 percutaneous coronary interventions, followed by no major adverse cardiovascular events such as death, acute myocardial infarction, acute cerebral ischemia/transient ischemic attack or hemorrhage, with 1 (2.1%) major adverse limb event in the form of shunt thrombosis encountered.