The role of intraoperative angiography in treating acute lower limb artery occlusion

Aim: To compare the results of surgical treatment of patients with acute lower limb artery occlusion with and without intraoperative angiography..

Materials and Methods: Comparative analysis was conducted on the surgical treatment outcomes of 119 patients with acute lower limb artery occlusion treated at the Vascular Surgery Center of the Clinical Hospital ≪Feofaniya≫ State Administrative Department from 2017 to 2022. The enrolled patients were divided into two groups: A - 70 (58,8%) patients, underwent open thrombectomy with Fogarty catheters in order to correct the acute lower limb ischemia; B - 49 (41,2%) patients, underwent open thrombectomy with Fogarty catheters followed by control intraoperative angiography. Based on the angiography results after thrombectomy, balloon angioplasty, open surgical interventions on the arteries, or thrombectomy alone were performed. The follow-up period was 12 months after the initial intervention.

Results: The cases of thrombectomy with positive immediate results tended to be higher in group B, as compared to the group A: 98,0% vs. 88,6%, respectively (p=0,080). The annual rate of recurrent artery occlusion was significantly higher in group A patients than in group B patients - 30,7% versus 8,3% (p<0,001), suggesting the benefits of the aforementioned approach at 12-months follow-up period.

Conclusions: The use of intraoperative angiography and arterial interventions, when indicated, during thrombectomy for acute lower limb artery occlusion significantly reduces the rate of recurrent arterial occlusive events over the 12-months observation period.