EXPERIENCE OF HYBRID SURGICAL TREATMENT FOR MULTILEVEL OCCLUSIVE-STENOTIC ARTERIAL LESIONS IN LOWER EXTREMITIES

Peripheral artery disease affects approximately 20% of individuals over the age 70 and is particularly prevalent among smokers diabetics. The increasing global prevalence metabolic syndrome, diabetes, smoking suggests a further rise in its occurrence. treatment this incurs significant economic costs, which are projected to continue growing. This associated with high rates disability, morbidity, mortality. Without revascularization, 20 40% patients face limb loss, die within six months. Conservative therapies often ineffective, leading surgical methods. In cases critical ischemia, revascularization performed improve blood flow distal stenotic or occlusive lesions. Open surgery remains standard care, demonstrating good preservation long-term outcomes. success bypass procedures depends on multiple factors. use endovascular techniques rapidly increasing, supported by substantial data. While reduces perioperative complications, choosing appropriate instrumentation assessing costs remain contentious. Method selection several For certain where open technically challenging impractical, provides viable solution for revascularization. such cases, all arterial lesion levels using combination methods indicated restore supply. Isolated single anatomical level insufficient rarely leads healing trophic changes. Hybrid surgery, involving during intervention, common approach. type procedure includes correction iliac segment femoral endarterectomy and/or infrainguinal bypass. Another option an "above knee bypass" tibial balloon angioplasty. Surgical hybrid demonstrates technical success, primary secondary patency rates, preservation, efficiency. article, we present two clinical lower extremity at Department Vascular Surgery M.V. Sklifosovsky Poltava Regional Clinical Hospital. These involve stage IV peripheral (Fontaine classification) caused atherosclerotic process. Computed tomography angiography digital subtraction were employed as distinct studying vascular bed routine patient management. method was based angiosomal targets suspected lesions initially diagnosed. objective study analyze effectiveness various ischemia resulting from multilevel occlusive-stenotic