[When is there an indication for primary femoral amputation in patients with vascular disease?]

Every patient suffering from arterial occlusive disease has to be considered a candidate for a bilateral amputation. Below-knee amputation is preferable if at all possible. Poor wound healing and reamputation at a higher level are factors to be expected in 20-30% of these patients. Therefore primary above-knee amputation is indicated only if a more distal amputation level is not possible, or if lower amputation offers no advantage to the patient. The question must be answered in each individual case.