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Re-intervention after vascular surgery for critical leg ischaemia
N J Cheshire1, M A Noone, J H Wolfe
1St Mary's Hospital Medical School, London, U.K.
European Journal of Vascular Surgery
|September 1, 1992
Summary
Secondary leg bypass surgery is common and often successful. Re-operation for critical leg ischemia significantly improves limb salvage rates, demonstrating the value of further intervention.
Area of Science:
- Vascular Surgery
- Reconstructive Surgery
- Critical Limb Ischemia
Background:
- Re-operation after leg arterial bypass is frequent, potentially viewed as failure or costly.
- Secondary reconstruction is sometimes avoided due to cost and perception of failure.
Purpose of the Study:
- To investigate the indications and outcomes of secondary interventions in patients with critical leg ischemia.
- To evaluate the impact of re-operation on limb salvage and graft patency.
Main Methods:
- Study included 395 patients undergoing primary arterial reconstruction for critical leg ischemia.
- Data collected on re-operations, limb salvage, graft patency, and mortality over a mean follow-up of 3 years.
Main Results:
- 44% of patients required further intervention; 30% for recurrent ischemia, 14% with patent grafts.
- Secondary reconstruction achieved a 64% success rate in limb salvage.
- Overall limb salvage was 86% at mean follow-up, with secondary graft patency at 79%.
Conclusions:
- Secondary reconstruction significantly improves limb salvage in critical leg ischemia.
- Timely re-intervention after primary graft failure is crucial for limb preservation.
- Despite high re-operation rates, secondary interventions offer substantial benefits in limb salvage.