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Updated: Dec 25, 2025
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Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity
Published on: January 31, 2025
785
[Does an attempt to save a limb always prolong the patient's life?]
Iu I Kazakov1, I B Lukin1, N Iu Sokolova2
1Tver State Medical University of the RF Ministry of Public Health, Tver, Russia; Regional Clinical Hospital, Tver, Russia.
Summary
Patients with critical limb ischemia and poor outflow experienced low survival and high cardiovascular events after revascularization. Repeat surgeries and amputations increased costs and worsened outcomes.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Health Economics
Background:
- Critical limb ischemia (CLI) with compromised outflow presents significant challenges.
- Femoropopliteal-tibial occlusive disease requires complex revascularization strategies.
- Low outflow competence portends a poor prognosis for lower limb revascularization.
Purpose of the Study:
- To evaluate overall survival in patients with CLI and poor outflow.
- To assess the incidence of major adverse cardiovascular events (MACE).
- To analyze economic expenditures associated with treatment strategies.
Main Methods:
- Retrospective study of 68 patients with CLI and low outflow competence.
- Primary arterial reconstruction in 48 patients; primary amputation in 20.
- Follow-up averaged 2 years, analyzing survival, MACE, and treatment costs.
Main Results:
- Redo arterial reconstructions and early amputation (within 11 months) correlated with reduced overall survival.
- High surgical risk and secondary interventions were linked to increased MACE.
- Secondary surgical interventions significantly escalated treatment costs.
Conclusions:
- Early revascularization failure and amputation in CLI patients with poor outflow negatively impact survival and increase cardiovascular risk.
- Repeat surgical interventions substantially increase healthcare costs.
- Optimizing initial revascularization is crucial for improving outcomes and managing costs in this high-risk population.
