Revascularization for severe limb ischemia.
Patients with rest pain or tissue necrosis (generally correlated with a tibial-brachial pressure index of less than 0.25) have a high probability of limb loss unless revascularization is done. These problems are usually associated with extensive and multiple segments of anatomical occlusive disease. A review of 359 patients with such problems indicates that revascularization was done in 86%, with initial success in 92% of patients. The durability of successful limb preservation proved good, with 90% of patients having a comfortable, useful limb to time of death or for one year or longer after operation. Cumulative patency rates were 90% at five years for aortofemoral reconstructions, 70% at five years for femoropopliteal bypasses, and 49% at five years for femorotibial grafts. Cumulative limb salvage rates were 93%, 81%, and 67% at five years in the same categories, respectively.
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001012:Aorta, Abdominal / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001366:Axillary Artery / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000401:mortality