PROGNOSTIC SIGNIFICANCE OF LESIONS OF THE LOWER EXTREMITY MAIN ARTERIES AND THE RESULTS OF THEIR CORRECTION IN DIABETIC FOOT SYNDROME

Objective. To determine the prognostic value of lesions of the main arteries of the lower extremities and the results of their correction in diabetic foot syndrome (DFS). Material and methods. A total of 452 patients with DFS were examined. Hemodynamically significant disturbances of the main blood flow in the lower extremity arteries were detected in 53.3% of cases. Reconstructive surgery on the lower extremity arteries was performed in 22.6% of patients. The surgical activity in the sample was 60.0%. Local interventions on the foot were performed in 48.2% of patients, of which 14.7% required a series of additional local interventions, and 6.4% ultimately required high amputation of the lower extremity (HALE). Primary HALE was used in 11.7% of cases, in 26% of these cases stump complications occurred which required additional surgery. Results. Risk factors for additional foot surgery after local interventions in the surgical treatment of DFS include lesions of the iliofemoral segment as well as combined lesions of the femoropopliteal segment and crural arteries. Combined pathology of the iliofemoral segment and crural arteries is associated with the risk of performing HALE after local interventions on the foot. The risk of performing primary HALE is associated with lesions of the iliofemoral segment, femoropopliteal segment, crural arteries, and combined lesions of the femoropopliteal segment and crural arteries. The risk of performing HALE during surgical treatment correlates with the presence of lesions of the iliofemoral segment, femoropopliteal segment, and crural arteries. Following reconstructive surgery on the main arteries of the lower extremities, the risk of additional foot surgery after local interventions and the risk of performing HALE after local foot interventions increases during subsequent treatment, while the risk of performing primary HALE and HALE during treatment decreases. Initial hemodynamically significant lesions of the main arteries of the lower extremities and performing reconstructive surgery on them do not affect the incidence of local complications after primary HALE. Conclusion. The obtained information can be used to predict results and determine rational tactics for surgical treatment of patients with DFS.