| Autor: |
Chausheva, N., Valchev, N., Dimitrov, D., Krastev, Pl. |
| Předmět: |
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| Zdroj: |
Neurosonology & Cerebral Hemodynamics; 2024 Supplement, Vol. 20, p107-108, 2p |
| Abstrakt: |
Introduction: We present our experience in the treatment of senile patient with multifocal atherosclerosis and severely impacted quality of life Clinical case: We describe a clinical case of a 86 years old patient with critical limb ischemia who received a femoroperoneal bypass with resection of the fibula in 2023 on the left lower extremity and perfect early result with dramatic improvement of the symptoms. Due to critical limb ischemia of the right lower extremity the patient received femoropopliteal bypass with prosthesis in 2024. During his second stay in the hospital the patient complained of chest pain and dispnea with massive elevation of troponin level. He was diagnosed with NSTEMI and but refused intervention at the time. Ten days later he is admitted in the cardiology unit in Gotse Delchev with clinical signs of right lower extremity ischemia. The treating physician performed thrombolysis with percutaneous angioplasty of the bypass with full restoration of the blood flow to the foot. Blood transfusion was also performed due to low haemoglobin level. Nevertheless the patient had anuria and progressing hypotension which led to patient's death 48 hours later. Discussion: In the recent years we observe an increasing number of patients with uncontrolled hypertension, diabetes, chronic renal disease. These patients are usually unsuitable for standard endovascular or open surgery procedures due to lack of outlet vessels. The only viable options for them is extraanatomical bypass surgery of deep venous arterialisation. Conclusion: Multidisciplinary approach is always needed in patients with multifocal atherosclerosis and failed attempts for revascularisation. In cases with other surgical options distal peroneal bypass with resection of the fibula offers the only appropriate solution for limb salvage. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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