Does preferential use of endovascular interventions by vascular surgeons improve limb salvage, control of symptoms, and survival of patients with critical limb ischemia? - 18/08/11
, Maureen S. O’Brien-Irr, R.N., M.S. b, Jim Lukan, M.D. b, Linda M. Harris, M.D. b, Maciej L. Dryjski, M.D. b, Gregory S. Cherr, M.D. a
Corresponding author. Division of Vascular Surgery, VA Western NY Healthcare System, 3495 Bailey Ave., Buffalo, NY, 14215. Tel.: +1-716-862-8937; fax: +1-716-862-8600.Abstract |
Background |
Our approach to patients with critical limb ischemia (CLI) underwent a rapid evolution from open surgery to preferential use of endovascular procedures. The goal of the current report was to evaluate the impact of this change on patients with CLI.
Methods |
Consecutive patients with CLI were compared between 3 periods: June 2001 to October 2002 (I) versus November 2002 to October 2003 (II) versus November 2003 to June 2005 (III).
Results |
A total of 275 patients (301 limbs, mean age 70 ± 11) underwent revascularization or primary major amputation (PA) for CLI (81 in I, 76 in II, 144 in III). PA decreased from 14.8%, 10.5%, and 3.5% (P < .001). Mean follow-up was 19.7 ± 13.6 months (range 0 to 57). Overall 24-month limb salvage (LS) was 60%, 69%, and 85% (P = .001), and 71%, 77%, and 88% following LS attempt (P = .017), with no difference in survival. Length of stay (LOS) decreased from 10.7 ± 12.1 (I) to 5.2 ± 6.2 days (III) (P = .001).
Conclusions |
Preferential use of endovascular interventions in patients presenting with CLI resulted in decreased number of PA, improved LS, and decreased LOS, without a difference in survival.
Le texte complet de cet article est disponible en PDF.Keywords : Critical limb ischemia, Endovascular interventions, Angioplasty, Arterial stent, Limb salvage
Plan
Vol 192 - N° 5
P. 572-576 - novembre 2006 Retour au numéro
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