Infra-inguinal arterial reconstruction for peripheral arterial disease: the Curaçao experience
H R Tromp1, J E C van Leeuwen, S Fieuws
1Department of Surgery, St Elisabeth Hospital, Curaçao. caquetio@hotmail.com
Insights
Infra-inguinal arterial bypass surgery is a viable option in Caribbean hospitals, achieving limb salvage rates of over 70% and comparable patency rates to larger studies.
Area of Science:
- Vascular Surgery
- Peripheral Arterial Disease Management
- Caribbean Healthcare Outcomes
Background:
- Peripheral arterial disease (PAD) prevalence and treatment in the Caribbean remain under-documented.
- This study reviews outcomes from a Caribbean hospital to address this knowledge gap.
Purpose of the Study:
- To evaluate the feasibility and outcomes of infra-inguinal arterial reconstructions in a Caribbean setting.
- To compare surgical results with international benchmarks.
Main Methods:
- Retrospective review of 108 infra-inguinal arterial reconstructions in 90 patients.
- Patient classification using Society for Vascular Surgery standards.
- Kaplan-Meier survival, limb salvage, and patency rate analysis.
- Cox regression for risk factor identification.
Main Results:
- Five-year limb salvage rate was 71.4%.
- Five-year primary patency rates: 50.8% overall, 82.4% for saphenous vein, 37.9% for prosthetic grafts.
- Five-year secondary patency rate was 75.1%.
Conclusions:
- Infra-inguinal arterial bypass surgery is feasible in small Caribbean hospitals.
- Outcomes demonstrate comparability to results from major international studies.
Background:
The prevalence and treatment of peripheral arterial disease in the Caribbean is not well documented. The aim of this study was to review the results from a small hospital in the Caribbean.
Methods:
One-hundred and eight infra-inguinal arterial reconstructions on 90 patients were retrospectively reviewed Patients were classified according to the categories suggested by the Ad Hoc Committee on Reporting Standards of the Joint Councils of the Society for Vascular Surgery. Follow-up ranged from 0 to 103.1 months. The Kaplan-Meier method was used to visualize survival, limb salvage rates and primary and secondary patency rates. Cox regressions were used to identify potential risk factors.
Results:
The limb salvage rates were 74.5% after one year and 71.4% after five years. Overall primary patency rates were 67.0 % after one year, 63.4% after three years and 50.8 % after five years. Overall secondary patency rates were 86.4% after one year and 75.1% after five years. The primary patency rate for autologous saphenous vein was 82.4% (SE 7.5%) after five years. The primary patency rates for prosthetic grafts were 62.1% (SE 8.5%) after one year; 56.9% (SE 9.2%) at three years and 37.9% (SE 16.7%) after five years.
Conclusion:
Infra-inguinal arterial bypass surgery is feasible in small Caribbean hospitals showing results comparable to major studies.
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