Abstract | BACKGROUND: Endovascular therapy for acute lower limb ischemia ( ALLI) has developed and demonstrated safety and efficacy. The purpose of this study was to assess clinical outcomes in patients treated for ALLI with conventional endovascular or surgical revascularization. METHOD: This study was a retrospective single-center review. Consecutive patients with ALLI treated with conventional endovascular revascularization (ER) without thrombolytic agent or surgical revascularization (SR) between 2008 and 2014 were investigated. The 1 year and 3 year amputation rate and mortality rate were assessed by time-to-event methods, including Kaplan-Meier estimation. RESULT: A total of 64 limbs in 62 patients with ALLI due to thromboembolism or thrombosis of a native artery, bypass graft, or previous stented vessel were included. The majority of limbs (90.9%) presented with Rutherford clinical categories 1 to 2 ischemia. Technical success rate was 95.5% in ER and 92.9% in SR group (p = 0.547). Overall amputation rates were 9.1% in ER versus 9.5% in SR after 1 year (p = 0.971) and 9.1% in ER versus 11.9% in SR after 3 year (p = 0.742). Overall mortality rates were 15% in ER versus 7.1% in SR after 1 year (p = 0.491) and 15% in ER versus 11.2% in SR after 3 year (p = 0.878). CONCLUSION: Endovascular or surgical revascularization of ALLI resulted in comparable outcomes in limb salvage and mortality rate at 1 year and 3 year. Conventional endovascular therapy without thrombolytic agent such as stenting, balloon angioplasty, or catheter-directed thrombosuction may be considered as a treatment option for ALLI.
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Authors | Keisuke Fukuda, Yoshiaki Yokoi |
Journal | Therapeutic advances in cardiovascular disease
(Ther Adv Cardiovasc Dis)
2020 Jan-Dec
Vol. 14
Pg. 1753944720924575
ISSN: 1753-9455 [Electronic] England |
PMID | 32438865
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Aged
- Aged, 80 and over
- Amputation, Surgical
- Angioplasty, Balloon
(adverse effects, mortality)
- Female
- Humans
- Ischemia
(diagnostic imaging, mortality, physiopathology, therapy)
- Limb Salvage
- Lower Extremity
(blood supply)
- Male
- Middle Aged
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Thrombectomy
(adverse effects, mortality)
- Time Factors
- Treatment Outcome
- Vascular Surgical Procedures
(adverse effects, mortality)
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