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Outcome of unreconstructed chronic critical leg ischaemia
1Fourth Department of Surgery, Helsinki University, Finland.
Insights
Unreconstructed chronic critical leg ischaemia (CLI) leads to poor outcomes, with high rates of amputation and mortality. Even without amputation, CLI significantly reduces survival and limb salvage, especially in bilateral cases.
Area of Science:
- Vascular Surgery
- Ischaemia Research
- Patient Outcomes
Background:
- Chronic critical leg ischaemia (CLI) is a severe condition with significant morbidity and mortality.
- Defining and assessing CLI outcomes is crucial for patient management.
Purpose of the Study:
- To evaluate the prognosis of patients with unreconstructed chronic critical leg ischaemia.
- To analyze outcomes with a focus on the definition of CLI.
Main Methods:
- Retrospective study with 1-year follow-up.
- Inclusion of 105 patients with 136 unreconstructed CLI legs.
- Assessment of major amputations and mortality rates.
Main Results:
- 54% of CLI legs survived at 1 year; 46% of patients survived at 1 year.
- Survival rates were lower for patients with non-amputated legs (28% at 1 year).
- Bilateral CLI indicated a worse prognosis; diabetes and arterial changes did not worsen outcomes.
Conclusions:
- Unreconstructed CLI is associated with a very poor prognosis for both survival and limb salvage.
- Patient selection may introduce bias, but findings highlight the severity of untreated CLI.
Objective:
To assess the outcome of unreconstructed chronic critical leg ischaemia with a special reference to the definition of CLI.
Design And Setting:
A retrospective study with 1 year follow-up in an academic referral center (Fourth Department of Surgery, Helsinki University Central Hospital).
Material:
105 consecutive unreconstructed patients with 136 critically ischaemic legs as defined by the European Consensus Document on Chronic Critical Leg Ischaemia.
Main Outcome Measures:
Major amputations and mortality.
Results:
81% of the 136 critically ischaemic legs survival 1 month, 70% three months and 54% one year. Of the 105 patients 93%, 77% and 46% were alive at 1, 3 and 12 months, respectively, whereas survival of patients with nonamputated leg was only 71%, 56% and 28%. Patients with bilateral CLI had a worse prognosis in terms of survival and leg salvage. The leg outcome was not worsened by the presence of diabetes nor by the distal extent of arterial changes.
Conclusions:
Although the selection of the present material is likely to cause some bias, unreconstructed CLI seemed to predict a very poor outcome in terms of survival and limb salvage.