Analysis of associated diseases in patients with acute critical lower limb ischemia.
2013
Introduction. Acute critical lower limb ischemia refers to the state of
severely impaired vitality of lower limbs due to acute occlusion of arterial
blood vessel by a thrombus or emboli. Surgical revascularization in the first
6-12 hours after the onset of symptoms gives the best results. However, a
high mortality rate and probability of limb loss make this problem more
debatable, and can be related with associated diseases. Material and Methods.
This research included 95 patients who had been operated within the first 12
hours after the onset of symptoms of critical limb ischemia. We collected the
following data: age and sex of patients, etiology of limb ischemia, type of
operation, associated diseases and outcome of treatment. Results and
Discussion. Most of the patients were 70 to 80 years old, both sexes being
equally represented. There was significantly more arterial embolism (70%)
than thrombosis on the prior arterial lesion. Most of the embolizations were
treated with Fogarty balloon catheter embolectomy (98%); however, a great
number of arterial thrombosis demanded more complex ”inflow” and ”outflow”
ensuring procedures such as thromboendarterectomy and bypass (33%). The
performed surgical procedures showed no statistical differences when final
outcome was analyzed. Amputation had to be performed in about 3% of the
patients and all of them were diabetics. Mortality rate in this research was
10.5% and 7/10 with this outcome had severe form of chronic myocardiopathy
and metabolic decompensation. Conclusion. Acute critical lower limb ischemia
should be treated surgically as soon as possible. Negative outcomes are
associated with comorbidity and general condition of the patient.
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