The influence of risk factors on immediate results of endovascular revascularization in combination with catheter-directed selectie thrombolysis in acute trombosis of peripheral arteries in patients with acute COVID-19 infection
A. V. Nikolsky,
V. N. Kravchuk,
N. A. Trofimov,
A. S. Mukhin,
A. D. Rybinsky,
D. V. Volkov,
D. V. Petrov,
E. G. Sharabrin,
V. A. Grishin https://doi.org/10.17238/2072-3180-2024-4-84-96
Abstract
Introduction. Acute limb ischemia is an urgent condition in which immediate revascularization is necessary. The risk of complications depends on the age of the patient, the cause of arterial thrombosis of the limb, and the presence of concomitant pathology: Coronary heart disease, CKD, respiratory failure, diabetes mellitus, urgency and duration of surgical treatment.
The aim of the study was to assess the impact of the presented risk factors on the results of endovascular revascularization in acute thrombosis in patients in the acute stage of COVID-19.
Materials and methods. The results of open surgical treatment of Rutherford class II acute limb ischemia in patients with acute stage COVID-19 (71 patients, group I) and 50 patients without COVID-19 (group II) were analyzed. The groups are comparable in demographic and clinical characteristics.
Results. Hospital mortality was 36,6 % in group I and 10 % in group II. The majority of deaths in group I were due to early retrombosis. Risk factors — coronary heart disease, CKD, diabetes and the emergency nature of surgery had a greater negative impact in group I against the background of coronavirus infection.
Conclusion. In patients in the acute stage of COVID-19, endovascular revascularization is associated with a high risk of complications and mortality in the early postoperative period compared with operated patients without coronavirus infection. The influence of all identified risk factors increases against the background of COVID-19, a statistically significant increase in the odds ratio of postoperative complications was revealed for such perioperative risk factors as coronary heart disease, respiratory failure, diabetes mellitus and chronic kidney disease, among the intraoperative factors, the emergency nature of the operation and the duration of surgery are significant.
About the Authors
A. V. Nikolsky
Federal State Budgetary Educational Institution of Higher Education "Volga Region Research Medical UnIersity";
State Budgetary Healthcare Institution of the Nizhny Novgorod region "City Clinical Hospital № 5 of the Nizhny Novgorod district of Nizhny Novgorod";
Federal State Budgetary Educational Institution of Higher Education "I. N. Ulyanov Chuvash State UnIersity";
Lobachevsky National Research Nizhny Novgorod State UnIersity
Russian Federation
Russian Federation
Nikolsky Alexander Viktorovich – Candidate of Medical Sciences, Assistant of the Department of Hospital Surgery named after B.A. Korolev, 603005, Nizhny Novgorod, Minin and Pozharsky Square 10/1;
evening cardiovascular surgeon, 603005 34 Nesterova str., Nizhny Novgorod;
Assistant at the Department of General Surgery and Oncology, 428015, Chuvash Republic, Cheboksary, Moskovsky ave., 15;
23 Gagarin Avenue, Nizhny Novgorod, 603022
V. N. Kravchuk
Federal State Budgetary Educational Institution of Higher Education "I.I. Mechnikov Northwestern State Medical UnIersity" of the Ministry of Health of the Russian Federation;
Federal State Budgetary Military Educational Institution of Higher Education "Military Medical Academy named after S.M. Kirov" of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Kravchuk Vyacheslav Nikolaevich – MD, Professor, Head of the Department of Cardiovascular Surgery, 191015, Kirochnaya str., 41, St. Petersburg;
Professor of the first Department of Surgery (Heart Development) named after P.A. Kupriyanov, Kirova metro station, 194044, Akademika Lebedeva str., 6, lit. Well, St. Petersburg
N. A. Trofimov
Budgetary institution of the Chuvash Republic "Republican Cardiological Dispensary" of the Ministry of Health of Chuvashia;
Federal State Budgetary Educational Institution of Higher Education "I. N. Ulyanov Chuvash State UnIersity";
State Autonomous Institution of Additional Professional Education "Institute of Advanced Training of Doctors" of the Ministry of Health of the Chuvash Republic;
Federal State Budgetary Educational Institution of Higher Education "Volga Region Research Medical UnIersity"
Russian Federation
Russian Federation
Trofimov Nikolay Alexandrovich – MD, Deputy Chief Physician for Surgery of the Chuvash Republic, 428020, Chuvash Republic, Cheboksary, Fedora Gladkova str., 29A;
Associate Professor of the Department of General Surgery and Oncology, 428015, Chuvash Republic, Cheboksary, Moskovsky Ave., 15;
Associate Professor of the Department of Surgery, 428018, Chuvash Republic, Cheboksary, Mikhail Sespel street, 27;
603005, Nizhny Novgorod
A. S. Mukhin
Federal State Budgetary Educational Institution of Higher Education "Volga Region Research Medical UnIersity"
Russian Federation
Russian Federation
Mukhin Alexey Stanislavovich – MD, PhD, Professor, Head of the Department of Hospital Surgery named after B.A. Korolev,
603005, Nizhny Novgorod, Minin and Pozharsky Square 10/1
A. D. Rybinsky
Federal State Budgetary Educational Institution of Higher Education "Volga Region Research Medical UnIersity";
State Budgetary Healthcare Institution of the Nizhny Novgorod region "City Clinical Hospital № 5 of the Nizhny Novgorod district of Nizhny Novgorod"
Russian Federation
Russian Federation
Rybinsky Alexey Dmitrievich – MD, PhD, Professor of the Department of Hospital Surgery named after B.A. Korolev, 603005, Nizhny Novgorod, Minin and Pozharsky Square 10/1;
603005, Nizhny Novgorod
D. V. Volkov
State Budgetary Healthcare Institution of the Nizhny Novgorod region "City Clinical Hospital № 5 of the Nizhny Novgorod district of Nizhny Novgorod"
Russian Federation
Russian Federation
Volkov Dmitry Vladimirovich – doctor for X-ray endovascular diagnosis and treatment,
603005, Nizhny Novgorod, 34 Nesterova str.
D. V. Petrov
State Budgetary Healthcare Institution of the Nizhny Novgorod region "City Clinical Hospital № 5 of the Nizhny Novgorod district of Nizhny Novgorod"
Russian Federation
Russian Federation
Petrov Denis Vladimirovich – Head of the Department of X-ray Endovascular Diagnosis and Treatment Methods, Doctor for X-ray Endovascular Diagnosis and Treatment,
603005, Nizhny Novgorod, st. Nesterova 34
E. G. Sharabrin
Federal State Budgetary Educational Institution of Higher Education "Volga Region Research Medical UnIersity"
Russian Federation
Russian Federation
Sharabrin Evgeny Georgievich – MD, PhD, Professor of the Department of X-ray Surgical Methods of Diagnosis and Treatment,
603005, Nizhny Novgorod, Minin and Pozharsky Square 10/1
V. A. Grishin
Lobachevsky National Research Nizhny Novgorod State UnIersity
Russian Federation
Russian Federation
Grishin Vladimir Anatolyevich – Candidate of Technical Sciences, Associate Professor of the Department of Probability Theory and Data Analysis at the Institute of Information Technology, Mathematics and Mechanics,
23 Gagarin Ave., Nizhny Novgorod, 603022
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Review
For citations:
Nikolsky A.V., Kravchuk V.N., Trofimov N.A., Mukhin A.S., Rybinsky A.D., Volkov D.V., Petrov D.V., Sharabrin E.G., Grishin V.A. The influence of risk factors on immediate results of endovascular revascularization in combination with catheter-directed selectie thrombolysis in acute trombosis of peripheral arteries in patients with acute COVID-19 infection. Moscow Surgical Journal. 2024;(4):84-96. (In Russ.) https://doi.org/10.17238/2072-3180-2024-4-84-96
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