[Extensive reconstructive surgery in thrombo-obliterating lesions of the lower limbs]

Expanded reconstructive operations in the aorto-iliac and femoro-popliteal segments in 148 patients with thrombo-obliterating lesions of the major lower limb arteries are described in detail. The volume of the operation was expanded by means of additional plastic methods in conventional reconstructions or inclusion of new vascular channels mainly in the formation of extra-anatomical shunts. A particular place was assigned in these operations to various modifications of additionally performed profundoplasty as well as to combinations of the principal intervention with endarterectomy, plastics of anastomoses, and intraoperative angiodilatation. Two plastic methods were applied simultaneously in 113 patients, three methods in 31 patients, and four methods in 4 patients. The late-term results of expanded aorto-iliac, extra-anatomical, femoro-popliteal shunts, and profundoplasty were positive in 81.4, 53, 60.6, and 67.6% of cases, respectively.