Acute limb ischemia in cancer patients: aggressive treatment is justified.
BACKGROUND
The outcome of cancer patients with acute limb ischemia (ALI) is not well defined. The purpose of this study is to report our experience treating patients with active malignancy who developed ALI and compare their outcome with non-cancer patients.


METHODS
A retrospective review of patients treated for ALI between 2009 and 2012 with ALI. We identified those patients who suffered from ALI and compared the outcome of those with active malignancy to those without malignancy.


RESULTS
Of 147 patients treated for ALI (122 lower extremity, 25 upper extremity), 24 (16%) were cancer patients. Mean follow-up was 9.8 months for the malignancy group and 13.4 months for the control. Perioperative mortality rates were similar among cancer and non-cancer patients (20% vs. 16%, respectively, NS). Freedom from major amputation at 30 months was similar (95% vs. 89%, NS). Long-term survival rates of cancer patients were significantly lower compared to non-cancer patients (45% vs. 77% respectively, P<0.05).


CONCLUSIONS
Treatment of ALI among cancer patients can be achieved with perioperative mortality and limb salvage rates comparable to non-cancer patients. Aggressive treatment is justified when treating cancer patients with ALI.
Department of Vascular Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel Aviv University Sackler School of Medicine, Tel Hashomer, Israel silverberg_d@msn.com.
Daniel
D
Silverberg
Department of Vascular Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel Aviv University Sackler School of Medicine, Tel Hashomer, Israel.
Tal
T
Yalon
Department of Vascular Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel Aviv University Sackler School of Medicine, Tel Hashomer, Israel.
Emanuel R
ER
Reinitz
Department of Vascular Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel Aviv University Sackler School of Medicine, Tel Hashomer, Israel.
Dmitry
D
Yakubovitch
Department of Vascular Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel Aviv University Sackler School of Medicine, Tel Hashomer, Israel.
Tal
T
Segev
Department of Vascular Surgery, The Chaim Sheba Medical Center, Affiliated to the Tel Aviv University Sackler School of Medicine, Tel Hashomer, Israel.
Moshe
M
Halak
D000208:Acute Disease; D000368:Aged; D000671:Amputation, Surgical; D017128:Embolectomy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*
Acute limb ischemia; cancer; embolectomy; malignancy; thrombolysis