Local anaesthetic for lower-limb revascularization in high-risk patients.
BACKGROUND
A few patients with critical limb ischaemia are believed to be too unfit for an attempt at revascularization using conventional anaesthesia.


METHODS
A retrospective analysis was undertaken of 46 revascularization procedures performed in high-risk patients for critical limb ischaemia between 1989 and 1995, in which local anaesthetic techniques were utilized in preference to general or spinal anaesthesia.


RESULTS
Cumulative survival rates at 6, 12 and 24 months were 67, 57 and 51 per cent. Primary patency rates were 77 per cent at 6 months, 67 per cent at 12 months and 53 per cent at 24 months, with associated limb salvage rates of 87, 87 and 79 per cent.


CONCLUSIONS
Selective use of local anaesthetic techniques extends the benefits of limb salvage to patients considered unfit for conventional anaesthesia.
Mackay
C A
CA
Accident and Emergency Department, Selly Oak Hospital, Birmingham, UK.
Razik
W
W
Simms
M H
MH
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001807:Blood Vessel Prosthesis / Q000379:methods; D003657:Decision Making; D005260:Female; D006085:Graft Survival; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency