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Do patients with critical limb ischaemia undergo multiple amputations after infrainguinal bypass surgery?
L Whittaker1, L D Wijesinghe, D C Berridge
1Department of Vascular and Endovascular Surgery, St James's University Hospital, Leeds, LS9 7TF, UK.
Background:
it has been suggested that an aggressive policy of bypass for limb salvage in critical ischaemia may result in patients subsequently undergoing multiple amputations. The aim of this study was to test this suggestion in the context of a dedicated Vascular Surgical Unit in a U.K. teaching hospital.
Methods:
three hundred and sixty-eight patients undergoing lower limb bypass operations for critical limb ischaemia between April 1991 and March 1999 were studied retrospectively. Their median age was 69 years (IQR 64--75) and 243 (66%) were men.
Results:
seventy-five operations were followed by one or more amputation (20%). Only 2% were multiple amputations. Age and sex had no effect on amputation rates, but emergency bypass operations led to a higher rate of amputation in those with critical limb ischaemia.
Conclusion:
patients with critical limb ischaemia who undergo lower limb bypass surgery rarely have subsequent multiple amputation.