Obliterating atherosclerosis of the lower extremities: problems of surgical treatment and prognosis
https://doi.org/10.52727/2078-256X-2025-21-4-429-439
Abstract
Peripheral artery disease is a manifestation of atherosclerosis, which can affect the arteries of the lower limbs. The most dangerous complication is chronic threatening ischemia of limbs. Without KIC revascularization often leads to limb loss. However, neither open surgical revascularization nor endovascular treatment provides long-term success and freedom from restenosis and failure of revascularization.
The aim of this literature review is to identify possible predictors of adverse results of endovascular revascularization of the lower extremities and possible strategies for their prevention.
Materials and methods. A systematic search of publications in PubMed, Scopus, Web of Science and eLibrary databases for the period 2020-2025 was carried out. Keywords used: «critical ischemia», «revascularization», «occlusion», «amputation», «disease of peripheral arteries», «restenosis». Selected and analyzed 56 sources that meet the inclusion criteria.
Results. The review analysed comprehensive approaches to APL treatment, including endovascular and surgical revascularization methods. Special attention is paid to the problem of restenosis and recurrent thrombotic events. Antithrombotic and lipid-lowering therapy after surgical interventions was evaluated.
Conclusions. A personalized approach, including surgical and medication treatments as well as digital solutions, is a promising way to improve the effectiveness of APS treatment and patient prognoses.
About the Authors
I. Delfan
Novosibirsk State University
Russian Federation
Russian Federation
Iliya Delfan, master’s student at the Institute of Medicine and Technology of the Federal State Autonomous Educational Institution of Higher Education
1, Pirogov st., Novosibirsk, 630090
N. G. Lozhkina
Novosibirsk State University;
Federal Research Center for Fundamental and Translational Medicine;
City Clinical Hospital № 1
Russian Federation
Russian Federation
Natalya G. Lozhkina, MD, PhD, Professor, Head of the Clinical and Experimental Cardiology Group
1, Pirogov st., Novosibirsk, 630090
2, Timakova st., Novosibirsk, 630060
6, Zalesskogo st., Novosibirsk, 630047
K. A. Kuznetsov
City Clinical Hospital № 1
Russian Federation
Russian Federation
Konstantin A. Kuznetsov, PhD, cardiovascular surgeon, state budgetary healthcare
6, Zalesskogo st., Novosibirsk, 630047
References
1. Piechocki M., Przewłocki T., Pieniążek P., Trystuła M., Podolec J., Kabłak-Ziembicka A. A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients-A Review: Part I-Epidemiology, Risk Factors, and Atherosclerosis-Related Diversities in Elderly Patients. J. Clin. Med., 2024; Mar 3; 13 (5): 1471. doi:10.3390/jcm13051471
2. Müller A., Bradaric C., Kafka A., Joner M., Cassese S., Xhepa Ph.E., Kufner S., Kastrati A., Laugwitz K.-L., Ibrahim T., Koppara T. Prevalence and patterns of in-stent neoatherosclerosis in lower extremity artery disease. EuroIntervention J. of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2023; 18 (17): 1462–1470. doi:10.4244/EIJ-D-22-00615
3. Sinclair A., Saeedi P., Kaundal A., Karuranga S., Malanda B., Williams R. Diabetes and global ageing among 65–99-yearold adults: Findings from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res. Clin. Pract., 2020. Apr; 162: 108078. doi: 10.1016/j.diabres.2020.108078. Epub 2020 Feb 14. PMID: 32068097
4. McDermott K.M., Bose S., Keegan A., Hicks C.W. Disparities in limb preservation and associated socioeconomic burden among patients with diabetes and/or peripheral artery disease in the United States. Semin Vasc Surg., 2023; Mar. 36 (1): 39–48. doi: 10.1053/j.semvascsurg.2023.01.007. Epub 2023 Feb 3. PMID: 36958896
5. Francesca G., Martini R. Current Opinion on Diagnosis of Peripheral Artery Disease in Diabetic Patients. Medicina (Kaunas, Lithuania), 2024; 60 (7): 1179. doi:10.3390/medicina60071179
6. Hutchings G., Kruszyna Ł., Nawrocki M.J., Strauss E., Bryl R., Spaczyńska J., Perek B., Jemielity M., Mozdziak P., Kempisty B., Nowicki M., Krasiński Z. Molecular Mechanisms Associated with ROS-Dependent Angiogenesis in Lower Extremity Artery Disease. Antioxidants (Basel), 2021. May 7; 10 (5): 735. doi: 10.3390/antiox10050735. PMID: 34066926; PMCID: PMC8148529
7. Moazzami K., Moazzami B., Roohi A., Nedjat S., Dolmatova E. Local intramuscular transplantation of autologous mononuclear cells for critical lower limb ischaemia. Cochrane Database Syst. Rev., 2014. Dec 19; 2014 (12): CD008347. doi: 10.1002/14651858.CD008347.pub3
8. Bisdas T., Torsello G., Stachmann A., Grundmann R.T. CRITISCH study group. Results of peripheral bypass surgery in patients with critical limb ischemia (CRITISCH registry). Gefasschirurgie, 2016; 21 (Suppl 2): 71–79. doi: 10.1007/s00772-016-0166-2. Epub 2016 Jul 13. PMID: 27551877; PMCID: PMC4974284
9. Adam D.J., Beard J.D., Cleveland T., Bell J., Bradbury A.W., Forbes J.F., Fowkes F.G., Gillepsie I., Ruckley C.V., Raab G., Storkey H. BASIL trial participants. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet, 2005. Dec 3; 366 (9501): 1925–34. doi: 10.1016/S0140-6736(05)67704-5. PMID: 16325694
10. Алекян Б.Г., Карапетян Н.Г., Чупин А.В. и др. Отдаленные результаты двух стратегий лечения больных с критической ишемией нижних конечностей в сочетании с ишемической болезнью сердца. Кардиол. вестн., 2022; 17 (2): 55–64. doi: 10.17116/Cardiobulletin20221702155
11. Аракелян В.С. Ампутация как ожидаемое последствие периферических артерий и пути улучшения прогноза сохранения конечностей. Ангиология и сосудистая хирургия. Журн. им. акад. А.В. Покровского, 2021; 27 (1): 182–190. https://doi.org/10.33529/angio2021101
12. Stone K., Fryer S., Faulkner J., Meyer M.L., Heffernan K., Kucharska-Newton A., Zieff G., Paterson C., Matsushita K., Hughes T.M., Tanaka H., Stoner L. Associations of lowerlimb atherosclerosis and arteriosclerosis with cardiovascular risk factors and disease in older adults: The Atherosclerosis Risk in Communities (ARIC) study. Atherosclerosis, 2022. Jan; 340: 53–60. doi: 10.1016/j.atherosclerosis.2021.10.014. Epub 2021 Nov 3.PMID: 34799100
13. Latkovskis G., Krievins D., Zellans E., Kumsars I., Krievina A., Angena A., Jegere S., Erglis A., Lacis A., Zarins C. Ischemia-Guided Coronary Revascularization Following Lower-Extremity Revascularization Improves 5-Year Survival of Patients With Chronic Limb-Threatening Ischemia. J. Endovasc. Ther., 2024. Apr 15: 15266028241245909. doi: 10.1177/15266028241245909. Epub ahead of print. PMID: 38616613
14. Beckman J.A., Schneider P.A., Conte M.S. Advances in Revascularization for Peripheral Artery Disease: Revascularization in PAD. Circ. Res., 2021. Jun 11; 128 (12): 1885– 1912. doi: 10.1161/CIRCRESAHA.121.318261. Epub 2021 Jun 10. PMID: 34110904
15. Lin P.K., Davis G.E. Extracellular Matrix Remodeling in Vascular Disease: Defining Its Regulators and Pathological Influence. Arterioscler. Thromb. Vasc. Biol., 2023. Sep; 43 (9): 1599–1616. doi: 10.1161/ATVBAHA.123.318237. Epub 2023 Jul 6. PMID: 37409533; PMCID: PMC10527588
16. Amlani V., Falkenberg M., Nordanstig J. The current status of drug-coated devices in lower extremity peripheral artery disease interventions. Prog. Cardiovasc. Dis., 2021. Mar–Apr; 65: 23–28. doi: 10.1016/j.pcad.2021.02.002. Epub 2021 Feb 13. PMID: 33587964
17. Huang Y., Xie X., Wang L. Endovascular Perclose ProGlide complication puncture site, treated successful by cutting balloon dilatation: A case report and literature review. Sci. Prog. 2024; 107 (3): 368504241278481. doi: 10.1177/00368504241278481. PMID: 39279272; PMCID: PMC11403694
18. Jiang Z., Ruan S., Zhao K., Pan S., Zhang W. Quantitative correlation between carotid or lower limb atherosclerosis and coronary heart disease: a retrospective observational study. Front. Endocrinol. (Lausanne). 2025. Mar 24; 16: 1570942. doi: 10.3389/fendo.2025.1570942. eCollection 2025. PMID: 40196459
19. Onofrei V., Crișan A., Adam C.A., Marcu D.T.M., Haba M.Ș.C., Tribus L.C., Ceasovschih A., Eșanu I.M., Petroaie A.D., Crișan-Dabija R., Leon-Constantin M.M., Cumpăt C., Mitu F. The Role Played by Novel Inflammatory Markers in Assessment of Peripheral Artery Disease. Medicina (Kaunas), 2023. Aug 28; 59 (9): 1557. doi: 0.3390/medicina59091557. PMID: 37763676
20. Soyoye D.O., Abiodun O.O., Ikem R.T., Kolawole B.A., Akintomide A.O. Diabetes and peripheral artery disease: A review. World. J. Diabetes, 2021. Jun 15; 12 (6): 827–838. doi: 10.4239/wjd.v12.i6.827. PMID: 34168731
21. Mueller T., Hinterreiter F., Poelz W., Haltmayer M., Dieplinger B. Mortality rates at 10 years are higher in diabetic than in non-diabetic patients with chronic lower extremity peripheral arterial disease. Vasc. Med., 2016. Oct; 21 (5): 445–452. doi: 10.1177/1358863X16643603. Epub 2016 Apr 11. PMID: 27067137
22. Хуан Y., Сюй M., Се L., Ван T., Хуан X., Lv X., Чэнь Y., Дин L., Линь L., Ван W. Ожирение и заболевание периферических артерий: анализ менделевской рандомизации. Атеросклероз, 2016; 247: L218–L224.
23. Мусса О., Ардиссино М., Муттони С., Фарадж А., Танг А., Хан О., Коллинз П., Джаффер У., Пуркаястха С. Долгосрочная заболеваемость и исходы заболеваний периферических сосудов, связанных с ожирением, после бариатрической хирургии. Langenbecks Arch. Surg., 2021; 406: 1029–1036.
24. Yadav A., Sawant V., Singh Bedi V., Yadav K. Dyslipidemia and peripheral arterial disease. Indian Heart J. 2024. Jan 13; 76 (Suppl 1): S86–S89. doi: 10.1016/j.ihj.2024.01.010
25. Li K., Ferguson T., Embil J., Rigatto C., Komenda P., Tangri N. Risk of Kidney Failure, Death, and Cardiovascular Events After Lower Limb Complications in Patients With CKD. Kidney Int. Rep., 2020. Dec 4; 6 (2): 381–388. doi: 10.1016/j.ekir.2020.11.010. eCollection 2021 Feb
26. Kotlyarov S. The Role of Smoking in the Mechanisms of Development of Chronic Obstructive Pulmonary Disease and Atherosclerosis. Int. J. Mol. Sci., 2023. May 13; 24 (10): 8725. doi: 10.3390/ijms24108725
27. Li D., Jia Y., Yu J., Liu Y., Li F., Liu F., Wu Q., Liao X., Zeng Z., Zeng R., Wan Z. Adherence to Healthy Lifestyle and the Risk of Function Limitations in Late Life: The Atherosclerosis Risk in Communities Study. Front. Aging. Neurosci., 2021. Aug 3; 13: 698699. doi: 10.3389/fnagi.2021.698699. eCollection 2021
28. Henni S., Bauer P., Le Meliner T., Hersant J., Papon X., Daligault M., Chretien J.M., Ammi M., Picquet J., Abraham P. High prevalence of exercise-induced ischemia in the asymptomatic limb of patients with apparently strictly unilateral symptoms and unilateral peripheral artery disease. Ther. Adv. Cardiovasc. Dis., 2019. Jan–Dec; 13: 1753944718819063. doi: 10.1177/1753944718819063.PMID: 30803404
29. Biscetti F., Ferraro P.M., Hiatt W.R., Angelini F., Nardella E., Cecchini A.L., Santoliquido A., Pitocco D., Landolfi R., Flex A. Inflammatory Cytokines Associated with Failure of Lower-Extremity Endovascular Revascularization (LER): A Prospective Study of a Population with Diabetes. Diabetes Care, 2019. Oct; 42 (10): 1939–1945. doi: 10.2337/dc19-0408. Epub 2019 Aug 1. PMID: 31371431
30. Stone P.A., Schlarb H.. Campbell J.E., Williams D., Thompson S.N., John M., Campbell J.R., AbuRahma A.F. C-reactive protein and brain natriuretic peptide as predictors of adverse events after lower extremity endovascular revascularization. J. Vasc. Surg., 2014. Sep; 60 (3): 652–60. doi: 10.1016/j.jvs.2014.03.254. Epub 2014 Apr 29. PMID: 24795153
31. Стародубова А.В., Чазова И.Е., Тутельян В.А., Никитюк Д.Б., Павловская Е.В., Кисляк О.А., Блинова Н.В., Брумберг А.А., Бубнова М.Г., Вараева Ю.Р., Гаппарова К.М., Гриневич В.Б., Громова М.А., Демидова Т.Ю., Дербенева С.А., Егорова В.В., Жернакова Ю.В., Карамнова Н.С., Костюкевич О.И., Косюра С.Д., Кошельская О.А., Ларина В.Н., Лейдерман И.Н., Лискова Ю.В., Ливанцова Е.Н., Остроумова О.Д., Павлова Н.Н., Погожева А.В., Саликова С.П., Самойлова Ю.Г., Теплова А.С., Хлынова О.В., Чернышева Т.В., Шарафетдинов Х.Х., Шулькина С.Г. Евразийские клинические рекомендации по питанию при сердечно-сосудистых заболеваниях (2024). Евразийский кардиологический журнал, 2024; (4): 6–67. https://doi.org/10.38109/2225-1685-2024-4-6-66
32. Park J.K., Jung W.B., Yoon J.H. Distribution Pattern of Atherosclerosis in the Abdomen and Lower Extremities and Its Association with Clinical and Hematological Factors. Vasc. Health Risk Manag., 2021. Jan 14; 17: 13–21. doi: 10.2147/VHRM.S287194. eCollection 2021. PMID: 33488084
33. Shameer K., Dow G., Glicksberg B.S., Johnson K.W., Ze Y., Tomlinson M.S., Readhead B., Dudley J.T., Kullo I.J. A Network-Biology Informed Computational Drug Repositioning Strategy to Target Disease Risk Trajectories and Comorbidities of Peripheral Artery Disease. AMIA Jt. Summits. Transl. Sci. Proc., 2018. May 18; 2017: 108–117. eCollection 2018. PMID: 29888052
34. Leonardo C.A., Biscetti F., Rando M.M., Nardella E., Pecorini G., Eraso L.H., Dimuzio P.J., GasbarriniA., Massetti M., Flex A. Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int. J. Mol. Sci., 2022. Sep 16; 23 (18):10814. doi: 10.3390/ijms231810814
35. Xhepa G., Inzerillo A., Constantinescu I., Faerber P., Gleyzolle A., Biondetti P., Del Grande F., Xhepa E., Mortellaro S., Carrafiello G., Pellegrino G., Ricoeur A. Limus Devices for the Treatment of SFA: Latest Outcomes and Future Perspectives. J. Clin. Med., 2025. May 21; 14 (10): 3594. doi: 10.3390/jcm14103594. PMID: 40429588; PMCID: PMC12112002
36. Закеряев А.Б., Виноградов Р.А., Сухоручкин П.В., Бутаев С.Р., Бахишев Т.Э., Ураков Э.Р., Барышев А.Г., Порханов В.А. Сравнительные результаты различных методов бедренно-подколенного шунтирования аутологичной веной с применением анализа методом сопоставления оценок склонностей (propensity score matching). Хирургия. Журнал им. Н.И. Пирогова, 2022; (10): 44–50. https://doi.org/10.17116/hirurgia202210144
37. Закеряев А.Б., Виноградов Р.А., Сухоручкин П.В., Бутаев С.Р., Бахишев Т.Э., Дербилов А.И., Ураков Э.Р., Барышев А.Г., Порханов В.А. Отдаленные результаты нового способа бедренно-подколенного шунтирования. Рос. кардиол. журн., 2022; 27 (8): 4843. https://doi.org/10.15829/1560-4071-2022-4843
38. Piechocki M., Przewłocki T., Pieniążek P., Trystuła M., Podolec J., Kabłak-Ziembicka A. A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients-A Review PART II-Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory. J. Clin. Med., 2024. Mar 5; 13 (5): 1508. doi: 10.3390/jcm13051508.PMID: 38592348
39. Li J., Lu W., Lin L., Wu J., Cheng G., Hu Q., Guo Y. Comparison of clinical outcomes of drug-coated balloons angioplasty vs. plain old balloons angioplasty for peripheral arterial disease: an umbrella meta-analysis. Front. Cardiovasc. Med., 2024. Nov 21; 11: 1511268. doi: 10.3389/fcvm.2024.1511268. PMID: 39639978; PMCID: PMC11617568
40. Крепкогорский Н.В., Бредихин Р.А. Современные методики подготовки аутовены к проведению шунтирующих операций (несистематический обзор) // Российский медико-биологический вестник имени академика И.П. Павлова, 2024. Т. 32, № 4. С. 669–680. DOI: https://doi.org/10.17816/PAVLOVJ321630
41. Koeckerling D., Raguindin P.F., Kastrati L., Bernhard S., Barker J., Quiroga Centeno A.C., Raeisi-Dehkordi H., Khatami F., Niehot C., Lejay A., Szeberin Z., Behrendt C.A., Nordanstig J., Muka T., Baumgartner I. Endovascular revascularization strategies for aortoiliac and femoropopliteal artery disease: a meta-analysis. Eur. Heart. J., 2023. Mar 14; 44 (11): 935–950. doi: 10.1093/eurheartj/ehac722. PMID: 36721954; PMCID: PMC10011342.
42. Zhou Y., Wang T., He H., Li Q., Wan Z., Lu P., Shu C. Comparative effectiveness of endovascular treatment modalities for de novo femoropopliteal lesions at long-term follow-up: A network meta-analysis of randomized controlled trials. Int. J. Cardiol., 2024. Jun 1; 404: 131977. doi: 10.1016/j.ijcard.2024.131977. Epub 2024 Mar 18. PMID: 38508322
43. Jarosinski M.C., Reitz K.M., Khamzina Y., Liang N.L., Sridharan N.D., Tzeng E. Antithrombotic therapy following lower extremity endovascular revascularization: The results of a survey of vascular specialists. JVS Vasc. Insights, 2024; 2: 100153. doi: 10.1016/j.jvsvi.2024.100153. Epub 2024 Oct 28. PMID: 39877294
44. Melnik T., Jordan O., Corpataux J.M., Delie F., Saucy F. Pharmacological prevention of intimal hyperplasia: A stateof-the-art review. Pharmacol. Ther., 2022. Jul; 235: 108157. ISSN 0163-7258. doi: 10.1016/j.pharmthera.2022.108157. Epub 2022 Feb 17. PMID: 35183591
45. Bonaca M.P., Bauersachs R.M., Anand S.S., Debus E.S., Nehler M.R., Patel M.R., Fanelli F., Capell W.H., Diao L., Jaeger N., Hess C.N., Pap A.F., Kittelson J.M., Gudz I., MátyásL., Krievins D.K., Diaz R., Brodmann M., Muehlhofer E., Haskell L.P., Berkowitz S.D., Hiatt W.R. Rivaroxaban in peripheral artery disease after revascularization. N. Engl. J. Med., 2020. May 21; 382 (21): 1994–2004. doi: 10.1056/NEJMoa2000052. Epub 2020 Mar 28. PMID: 32222135
46. Bonaca M.P., Szarek M., Debus E.S., Nehler M.R., Patel M.R., Anand S.S., Muehlhofer E., Berkowitz S.D., Haskell L.P., Bauersachs R.M. Efficacy and safety of rivaroxaban versus placebo after lower extremity bypass surgery: A post hoc analysis of a «CASPAR like» outcome from VOYAGER PAD. Clin. Cardiol., 2022. Dec; 45 (12): 1143–1146. doi: 10.1002/clc.23926. Epub 2022 Oct 17. PMID: 36251249; PMCID: PMC9748742
47. Tepe G., Bantleon R., Brechtel K., Schmehl J., Zeller T., Claussen C.D., Strobl F.F. Management of peripheral arterial interventions with mono or dual antiplatelet therapy – the MIRROR study: a randomised and double-blinded clinical trial. Eur Radiol., 2012;22(9):1998–2006. doi: 10.1007/s00330-012-2441-2. Epub 2012 May 10.PMID: 22569995
48. Zou J., Xia Y., Yang H., Ma H., Zhang X. Hybrid endarterectomy and endovascular therapy in multilevel lower extremity arterial disease involving the femoral artery bifurcation. Int. Surg., 2012; 97 (1): 56–64. doi: 10.9738/0020-8868-97.1.56. PMID: 23102001
49. Abola M.T.B., Golledge J., Miyata T., Rha S.W., Yan B.P., Dy T.C., Ganzon M.S.V., Handa P.K., Harris S., Zhisheng J., Pinjala R., Robless P.A., Yokoi H., Alajar E.B., Bermudez-Delos Santos A.A., Llanes E.J.B., Obrado-Nabablit G.M., Pestaño N.S., Punzalan F.E., Tumanan-Mendoza B. Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease: A Report from the Asian Pacific Society of Atherosclerosis and Vascular Disease Asia-Pacific Peripheral Artery Disease Consensus Statement Project Committee. J. Atheroscler. Thromb., 2020. Aug 1; 27 (8): 809–907. doi: 10.5551/jat.53660. Epub 2020 Jul 4. Erratum in: J. Atheroscler. Thromb. 2020. Dec 1; 27 (12): 1374. doi: 10.5551/jat.ER53660. Erratum in: J Atheroscler Thromb. 2021; 28 (3): 304. doi: 10.5551/jat.ER48843. PMID: 32624554; PMCID: PMC7458790
50. Рекомендации ESC 2024 года по ведению пациентов с заболеваниями периферических артерий и аорты: основные положения. Бюл. мед. науки, 2025; 2: 113–128. DOI: 10.31684/25418475-2025-2-113 URL: https://newbmn.asmu.ru/bmn/article/view/9967
51. Piechocki M., Przewłocki T., Pieniążek P., Trystuła M., Podolec J., Kabłak-Ziembicka A. A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients-A Review PART II-Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory. J. Clin. Med., 2024. Mar 5; 13 (5): 1508. doi: 10.3390/jcm13051508. PMID: 38592348; PMCID: PMC10934701
52. Ложкина Н.Г., Добровольская Н.П., Артеменко С.Н., Шипунов М.В., Шаронин А.Д., Кольтюгина В.А., Тимофеев В.С., Воевода М.И. Эффективность и безопасность инклисирана, эволокумаба и алирокумаба у пациентов высокого, очень высокого и экстремального сердечно-сосудистого риска. Рос. кардиол. журн., 2025; 30 (3): 5869. https://doi.org/10.15829/1560-4071-2025-5869. EDN: RZWJCG
53. Нарушения липидного обмена. Клинические рекомендации 2023. Российское кардиологическое общество. Рос. кардиол. журн., 2023; 28 (5): 5471. doi:10.15829/1560-4071-2023-5471
54. Седых Д.Ю., Кашталап В.В., Хрячкова О.Н., Петрова Т.С., Барбараш О.Л. Интенсификация липидснижающей терапии у пациентов очень высокого риска: возможности комбинации с ингибиторами PCSK9. Рос. кардиол. журн., 2022; 27 (6): 5030. https://doi.org/10.15829/1560-4071-2022-5030
55. Корнева В.А., Кузнецова Т. Ю., Скопец И.С. и др. Опыт применения ингибитора PCSK9 алирокумаба у пациентов экстремально высокого сердечно-сосудистого риска. Кардиология, 2020; 60 (8): 71–77. doi:10.18087/cardio.2020.8.n1046
56. Чаулин А. М. Новые группы гиполипидемических препаратов, основанные на ингибировании пропротеиновой конвертазы субтилизин-кексинового типа 9 (PCSK9). Часть 1. Клин. мед., 2020; 98 (11–12): 739–44. doi:10.30629/0023-2149-2020-98-11-12-739-744
Review
For citations:
Delfan I., Lozhkina N.G., Kuznetsov K.A. Obliterating atherosclerosis of the lower extremities: problems of surgical treatment and prognosis. Ateroscleroz. 2025;21(4):429-439. (In Russ.) https://doi.org/10.52727/2078-256X-2025-21-4-429-439
Views:
62
JATS XML
Email this article 
