Surgical possibilities in the treatment of patients with critical lower limb ischemia

Treatment of occlusive lesions of the arteries of the lower extremities remains an urgent problem, leading to permanent disability, and even death, and therefore it is rightfully considered one of the most dangerous conditions in the group of diseases of the circulatory system. This review article presents various treatment methods and their comparative analysis, which makes it possible to choose less traumatic and more effective methods aimed at reducing the frequency of amputations of the lower extremities. Such as bypass surgery and balloon angioplasty with or without a stent; application of the angiosomal theory of limb revascularization; tactics of aggressive surgical wound rehabilitation or staged low-traumatic bandages; vacuum therapy in the treatment of trophic ulcers; comparative analysis of single-stage and multi-stage amputations in critical lower limb ischemia. As a result of the analysis of the literature, it can be stated that the treatment of CINK is based on: 1. Adequate revascularization with obtaining a main or collateral blood flow in the area of trophic defects; 2. Proper wound care, using aggressive methods of removing dead tissues and vacuum dressings; 3.Staged (small) amputations as necessary.

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