Особенности поражения артерий нижних конечностей и клинические исходы эндоваскулярных вмешательств у больных сахарным диабетом с критической ишемией нижних конечностей и хронической болезнью почек

Цель. Оценить выраженность кальциноза артерий нижних конечностей, проанализировать отдаленные результаты чрескожной транслюминальной баллонной ангиопластики (ЧТБА) и клинические исходы у пациентов с сахарным диабетом (СД), критической ишемией нижних конечностей (КИНК) и хронической болезнью повек (ХБП).
Материалы и методы. У 48 пациентов без ХБП и 46 пациентов с ХБП и КИНК проведена бесконтрастная мультиспиральная компьютерная томография (МСКТ) нижних конечностей для количественной оценки степени кальциноза артерий голени, анализ отдаленных исходов ЧТБА артерий нижних конечностей.
Результаты. Отдаленные клинические исходы ЧТБА достоверно хуже в группе пациентов с ХБП, чем у лиц без ХБП. Тем не менее, сохранение конечности и выживаемость обследуемых групп  пациентов за 2-летний период наблюдения достигают удовлетворительных значений, 74% и 72% соответственно.
Выводы. Несмотря на технические трудности ЧТБА у больных СД, КИНК с нарушением выделительной функции почек, эндоваскулярное вмешательство позволяет избежать высокой ампутации конечности и повысить выживаемость в большинстве случаев.

сахарный диабет, критическая ишемия нижних конечностей, чрескожная транслюминальная баллонная ангиопластика, индекс тибиального кальция, ультразвуковое дуплексное сканирование

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