Risk factors associated with acute lower extremity ischemia after coronary revascularization.
Acute lower extremity ischemia (ALEI) is a recognized complication of coronary revascularization that can lead to emergent lower extremity revascularization, amputation, and death. Patients with correctable coronary artery disease have a high incidence of lower extremity arterial occlusive disease (AOD). But, despite the known high correlation between AOD and coronary artery disease, the status of the lower extremity vasculature in patients undergoing coronary revascularization may be overlooked until the lower extremity becomes profoundly ischemic. Data from a retrospective review of 35,000 coronary revascularization procedures identified 55 patients who developed ALEI, subsequent to their cardiac procedures. Risk factors for ALEI included femoral artery instrumentation, previous coronary revascularization, hemodynamic instability, and documented AOD. Means of identifying patients at risk for ALEI are discussed.
Kohlman-Trigoboff
Debra
D
Washington Hospital Center, Section of Vascular Surgery, Washington, DC 20010, USA.
Gongora
Enrique
E
Stanford
Jon
J
Smith
Bruce M
BM
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000209:etiology*; D003327:Coronary Disease / Q000150:complications* / Q000628:therapy*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007511:Ischemia / Q000453:epidemiology / Q000209:etiology*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology*; D010808:Physical Examination; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome