Nontraumatic lower-extremity acute arterial ischemia.
BACKGROUND
The outcome of arterial bypass reconstruction in the setting of acute arterial ischemia has not been well defined.


METHODS
This retrospective review consists of 71 consecutive patients (54 with native arterial thrombosis, 17 with graft thrombosis) who underwent an urgent/emergent arterial bypass reconstruction for acute arterial ischemia with threatened limb viability.


RESULTS
The 30-day mortality and major amputation rates were 9.9% and 7.1%, respectively. Death, limb loss, or both, were associated with a paralytic limb (P = 0.001) and congestive heart failure (P = 0.03). Overall, 45 of 71 (63%) patients were discharged with limb salvage and ambulatory function. Cumulative graft patency was 77% and 65% at 1 and 2 years, respectively, and closely approximated the 1- and 2-year limb-salvage rates of 76% and 63%, respectively.


CONCLUSIONS
Arterial bypass reconstructions appear warranted in acute arterial ischemia, in that a majority of patients retain a functional viable limb. Late graft thrombotic complications limit long-term benefit.
Nypaver
T J
TJ
Division of General Surgery, University of Kentucky--Albert B. Chandler Medical Center, Lexington, USA.
Whyte
B R
BR
Endean
E D
ED
Schwarcz
T H
TH
Hyde
G L
GL
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation; D003627:Data Interpretation, Statistical; D004630:Emergencies; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000601:surgery; D013997:Time Factors; D014654:Vascular Patency