Nontraumatic lower-extremity acute arterial ischemia

Timothy J. Nypaver, Brian R. Whyte, Eric D. Endean, Thomas H. Schwarcz, Gordon L. Hyde

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)147-152
Number of pages6
JournalAmerican Journal of Surgery
Volume176
Issue number2
DOIs
StatePublished - Aug 1998

ASJC Scopus subject areas

  • Surgery

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