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Acute lower limb ischemia: current state of the problem

Authors: Shchegolev A.A.1 2, Papoyan S.A.1 2 3, Gromov D.G.1 2, Asaturyan K.S.3

Company: 1 Pirogov Russian National Research Medical University, Moscow, Russian Federation
2 Inozemtsev City Clinical Hospital, Moscow, Russian Federation
3 Research Institute of Healthcare Organization and Medical Management, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2024-18-2-176-182

For citation: Shchegolev A.A., Papoyan S.A., Gromov D.G., Asaturyan K.S. Acute lower limb ischemia. Current state of the problem. Creative Cardiology. 2024; 18 (2): 176–182 (in Russ.). DOI: 10.24022/1997-3187-2024-18-2-176-182

Received / Accepted:  25.01.2024 / 29.03.2024

Keywords: acute lower limb ischemia hybrid interventions endovascular treatment thrombolysis



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Abstract

Acute lower limb ischemia is a severe reduction in blood flow to the extre mities due to acute peripheral arterial occlusion or shunt, which can lead to amputation regardless of the underlying cause if not treated appropriately. The mortality rate, according to the literature, is 15–20% due to concomitant diseases such as cardiovascular, cerebrovascular diseases and ischemia-reperfusion injury. In the treatment of this difficult disease, endovascular methods, open surgery, and hybrid revascularization interventions are used. It should also be noted that thrombolytic therapy has been used to treat this pathology since the 1950s. Due to improvements in surgical techniques, the rate of amputation has decreased in recent decades, but survival rates have not actually changed significantly. This article reviews the literature on various methods of treating acute ischemia of the lower extremities. The choice of treatment method in certain situations for a given pathology is not straightforward and generally requires an individual approach.

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About Authors

  • Aleksandr A. Shchegolev, Dr. Med. Sci., Professor, Head of Department of Hospital Surgery, Faculty of Pediatrics Pirogov RNRMU, Head of the Surgical Clinic of the Inozemtsev CCH; ORCID
  • Simon A. Papoyan, Cand. Med. Sci., Associate Professor, Head of Department Professor of the Department of Hospital Surgery, Faculty of Pediatrics of Pirogov RNRMU, Head of Department, Cardiovascular Surgeon of Inozemtsev CCH, Head of the Organizational and Methodological Department for Cardiovascular Surgery of the RIHOMM; ORCID
  • Dmitriy G. Gromov, Dr. Med. Sci., Head of Department, Chief of Chair X-ray Endovascular Methods of Diagnostics and Treatment of Pirogov RNRMU, Head of the Department of X-ray Endovascular Diagnostics and Treatment of the Inozemtsev CCH; ORCID
  • Karen S. Asaturyan, Cardiovascular Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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