[Distal reconstructions with the autovein in situ for critical ischemia of lower extremities in elderly and senile patients].

The work was devoted to the problem of early and late thromboses of transplants at femoro-popliteal-tibial shunting. One of the main causes of frequent thromboses of the shunts was soundly shown to be high peripheral vascular resistance. The investigation has shown efficiency of using collaterals of the large subcutaneous vein as collectors of unloading the shunt in order to decrease the peripheral vascular resistance in femorodistal reconstruction with the autovein in the in situ position. In a year the cumulative passability of the shunt in the main group patients treated by the method of unloading the shunt with the help of non-ligated autovein collaterals made up 75.1% compared to 69.3% in patients of the group of comparison, and within 5 years 53.8% and 45.2% respectively. The index of safety of the extremity in a year was 81.5% in the main group patients, and 73.2% in control group patients, in 5 years 64% and 46.5% that demonstrated advantages of the method of leaving the functioning tributaries of the large subcutaneous vein intact after reconstruction.