Obliterating atherosclerosis of the lower extremities: problems of surgical treatment and prognosis

Peripheral artery disease is a manifestation of atherosclerosis, which can affect the arteries of the lower limbs. The most dangerous complication is chronic threatening ischemia of limbs. Without KIC revascularization often leads to limb loss. However, neither open surgical revascularization nor endovascular treatment provides long-term success and freedom from restenosis and failure of revascularization. The aim of this literature review is to identify possible predictors of adverse results of endovascular revascularization of the lower extremities and possible strategies for their prevention. Materials and methods . A systematic search of publications in PubMed, Scopus, Web of Science and eLibrary databases for the period 2020-2025 was carried out. Keywords used: «critical ischemia», «revascularization», «occlusion», «amputation», «disease of peripheral arteries», «restenosis». Selected and analyzed 56 sources that meet the inclusion criteria. Results . The review analysed comprehensive approaches to APL treatment, including endovascular and surgical revascularization methods. Special attention is paid to the problem of restenosis and recurrent thrombotic events. Antithrombotic and lipid-lowering therapy after surgical interventions was evaluated. Conclusions . A personalized approach, including surgical and medication treatments as well as digital solutions, is a promising way to improve the effectiveness of APS treatment and patient prognoses.