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Am J Surg. 1998 Aug;176(2):147-52.

Nontraumatic lower-extremity acute arterial ischemia.

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1
Division of General Surgery, University of Kentucky--Albert B. Chandler Medical Center, Lexington, USA.

Abstract

BACKGROUND:

The outcome of arterial bypass reconstruction in the setting of acute arterial ischemia has not been well defined.

METHODS:

This retrospective review consists of 71 consecutive patients (54 with native arterial thrombosis, 17 with graft thrombosis) who underwent an urgent/emergent arterial bypass reconstruction for acute arterial ischemia with threatened limb viability.

RESULTS:

The 30-day mortality and major amputation rates were 9.9% and 7.1%, respectively. Death, limb loss, or both, were associated with a paralytic limb (P = 0.001) and congestive heart failure (P = 0.03). Overall, 45 of 71 (63%) patients were discharged with limb salvage and ambulatory function. Cumulative graft patency was 77% and 65% at 1 and 2 years, respectively, and closely approximated the 1- and 2-year limb-salvage rates of 76% and 63%, respectively.

CONCLUSIONS:

Arterial bypass reconstructions appear warranted in acute arterial ischemia, in that a majority of patients retain a functional viable limb. Late graft thrombotic complications limit long-term benefit.

PMID:
9737621
[Indexed for MEDLINE]
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