Chronic critical leg ischaemia must include leg ulcers.
OBJECTIVE
In a previous series on conservative treatment in patients with leg ulcers and severe arterial occlusive disease (systolic digital blood pressure (SDBP) < 30 mmHg) a 70% risk of leg amputation and a negligeable potential for ulcerhealing was found. This series assess the efficacy of arterial reconstruction in such patients.


METHODS
Retrospective study of consecutive patients in a department of vascular surgery and of dermatology in cooperation with the wound healing center.


METHODS
Thirty-nine patients with 42 ulcerated legs underwent arterial revascularisation. 88% of the procedures were distal to the inguinal ligament.


RESULTS
One patient died postoperatively (3%). Seven (18%) had wound complications, but none had graft infections. After 1 year the cumulative secondary patency was 90%, ulcer healing 70% and the limb salvage 90%. Thus only four legs (10%) had been amputated.


CONCLUSIONS
Arterial revascularisation for leg ulcers is indicated when conservative treatment fails. Legs with ulceration and SDBP < 30 mmHg should be included in the concept of chronic critical ischaemia.
Konradsen
L
L
Department of Thoracic and Vascular Surgery L, Bispebjerg Hospital, Copenhagen Wound Healing Center, University of Copenhagen, Denmark.
Wounlund
J
J
Holstein
P
P
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006083:Graft Occlusion, Vascular; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D007871:Leg Ulcer / Q000209:etiology* / Q000628:therapy; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures