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Nontraumatic lower-extremity acute arterial ischemia
T J Nypaver1, B R Whyte, E D Endean
1Division of General Surgery, University of Kentucky--Albert B. Chandler Medical Center, Lexington, USA.
American Journal of Surgery
|September 16, 1998
Summary
Arterial bypass reconstruction for acute limb ischemia offers limb salvage in most cases. However, late graft thrombosis can limit long-term benefits, necessitating further research into improved outcomes.
Area of Science:
- Vascular Surgery
- Acute Limb Ischemia
- Arterial Reconstruction
Background:
- The clinical outcomes of arterial bypass reconstruction for acute arterial ischemia remain incompletely understood.
- Defining the effectiveness of urgent arterial bypass is crucial for managing limb-threatening conditions.
Purpose of the Study:
- To evaluate the outcomes of urgent/emergent arterial bypass reconstruction in patients with acute arterial ischemia and threatened limb viability.
- To identify factors associated with mortality and limb loss in this patient cohort.
Main Methods:
- Retrospective review of 71 consecutive patients undergoing urgent/emergent arterial bypass for acute arterial ischemia.
- Analysis included patients with native arterial thrombosis and graft thrombosis.
Main Results:
- The 30-day mortality rate was 9.9%, and major amputation rate was 7.1%.
- Limb salvage and ambulatory function were achieved in 63% of patients.
- Cumulative graft patency at 1 and 2 years was 77% and 65%, respectively, closely mirroring limb-salvage rates.
Conclusions:
- Arterial bypass reconstruction is a viable option for acute arterial ischemia, enabling limb salvage in the majority of patients.
- Long-term benefits are potentially limited by late graft thrombotic complications.