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Upper limb ischemia: 20 years experience from a single center.
Jean Deguara1, Tahir Ali, Bijan Modarai
1Academic Department of Surgery, St. Thomas' Hospital, London, United Kingdom.
Vascular
|July 6, 2005
Summary
This study reviewed 184 upper limb revascularization procedures over 20 years. Embolectomy had high mortality, emphasizing the need to manage cardiac comorbidities for better outcomes.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Background:
- Upper limb revascularization is crucial for limb salvage.
- Understanding outcomes and complications is vital for surgical practice.
Purpose of the Study:
- To analyze a single center's 20-year experience with upper limb revascularization.
- To identify indications, procedures, and outcomes of upper limb revascularization.
Main Methods:
- Retrospective review of 184 upper limb revascularization procedures (operative and endovascular) from 1983-2003.
- Categorization of patients by indication: thromboembolic events, traumatic injury, chronic ischemia, subclavian steal syndrome, thoracic outlet compression, and iatrogenic injuries.
Main Results:
- Thromboembolic events (35%), traumatic injuries (31%), and chronic ischemia (17%) were primary indications.
- Mortality for upper limb revascularization was 8.7%, with most deaths following embolectomy (18.2% mortality).
- Chronic ischemia group had 6.9% mortality, with angioplasty and bypass being common interventions.
Conclusions:
- Upper limb embolectomy carries significant mortality, comparable to lower limb procedures.
- Cardiac comorbidity is a major factor in mortality after upper limb revascularization.
- Active screening and management of cardiac conditions are essential to improve patient outcomes.