METHOD FOR TREATING OBLITERATING ATHEROSCLEROSIS OF THE VESSELS OF THE LOWER LIMBS OF THE ILIOFEMORAL SEGMENTS Russian patent published in 2022 - IPC A61B17/00 A61F2/82 A61M25/10 A61B17/3207 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely, to vascular surgery. Open access to the common femoral artery is made. A balloon is then passed endovascularly from the access through the arteries of the upper limbs in the antegrade direction. Balloon occlusion is performed at the level of the expected detachment of the plaque from the iliac artery, wherein the diameter of the balloon catheter is selected in accordance with the diameter of the common iliac artery based on the angiography data. Then a longitudinal arteriotomy with a length of 2 to 2.5 cm is performed. After that, the plaque in the common femoral artery is separated transmedianly, preserving the outer elastic membrane. Under X-ray examination, a loop endarterectomy is performed in the retrograde direction with a Vollmar ring up to the distal edge of the occluding balloon using the previously conducted guide. Detachment of the plaque is initiated, the atherosclerotic substrate is secured in the ring by rotational movements along the axis of the tool and then removed from the lumen. If the plaque herein is not localised, the distal portion of the atheromatously altered intima is sutured. Then the longitudinal arteriotomy is sutured using patches made of synthetic materials or autogenous vein, and the blood flow is started. Angiographic control of the reconstruction area is conducted from the dianostic catheter installed in the infrarenal aorta. A puncture of the common femoral artery is performed from an open access, a 6F - 11 cm introducer is installed, a hydrophilic guide is passed into the infrarenal aorta in the retrograde direction through the area of dissection of the iliac artery. A self-opening stent, selected based on the data of angiography performed after loop endarterectomy, is then passed in the retrograde direction, implanted, and then the stented segment is post-dilated with a balloon catheter of a diameter 1 to 2 mm smaller than the diameter of the stent.

EFFECT: method does not violate the layering of the atheromatously altered arterial wall at the site of clamping with a vascular clamp, improves the results of treatment of closed loop thrombendarterectomy from iliac arteries in patients with obliterating atherosclerosis, while shortening the duration of endothelisation of the stented and reducing the financial burden on healthcare.

1 cl, 2 ex