OBJECTIVES: Data from the STILE study have indicated that for patients with subacute limb ischaemia due to native vessel occlusion, surgery is both more effective, and durable than thrombolysis. The purpose of this study was to evaluate the outcome of an aggressive surgical approach in patients presenting with acute limb-threatening ischaemia. DESIGN: Details of patients presenting with salvageable acute limb ischaemia due to native artery occlusion over a 6-year period in a University hospital vascular unit setting were obtained from the vascular audit and the outcome of the surgical management of these patients was analysed. RESULTS: One hundred and seventy-four consecutive patients underwent surgery for acute native vessel limb ischaemia (76% lower, 24% upper limb). Fogarty thrombectomy or embolectomy was initially performed in 153 (89%) patients. Of these, 37 (24%) immediately underwent a further procedure: 28 (18%) had on-table thrombolysis and 14 (9%) underwent vascular reconstruction. Twenty-six patients (15%) underwent further limb salvage surgery within 30 days. Life table analysis demonstrated a limb salvage rate of 88% and 76% at 30 days and 2 years, respectively. Patient survival was 75% and 48% at the same time intervals. CONCLUSIONS: These results demonstrate that a role for aggressive surgical intervention still exists, resulting in high limb salvage rates.
OBJECTIVES: Data from the STILE study have indicated that for patients with subacute limb ischaemia due to native vessel occlusion, surgery is both more effective, and durable than thrombolysis. The purpose of this study was to evaluate the outcome of an aggressive surgical approach in patients presenting with acute limb-threatening ischaemia. DESIGN: Details of patients presenting with salvageable acute limb ischaemia due to native artery occlusion over a 6-year period in a University hospital vascular unit setting were obtained from the vascular audit and the outcome of the surgical management of these patients was analysed. RESULTS: One hundred and seventy-four consecutive patients underwent surgery for acute native vessel limb ischaemia (76% lower, 24% upper limb). Fogarty thrombectomy or embolectomy was initially performed in 153 (89%) patients. Of these, 37 (24%) immediately underwent a further procedure: 28 (18%) had on-table thrombolysis and 14 (9%) underwent vascular reconstruction. Twenty-six patients (15%) underwent further limb salvage surgery within 30 days. Life table analysis demonstrated a limb salvage rate of 88% and 76% at 30 days and 2 years, respectively. Patient survival was 75% and 48% at the same time intervals. CONCLUSIONS: These results demonstrate that a role for aggressive surgical intervention still exists, resulting in high limb salvage rates.
Authors: D Laganà; G Carrafiello; D Lumia; F Fontana; M Mangini; F A Vizzari; G Piffaretti; C Fugazzola Journal: Radiol Med Date: 2010-12-03 Impact factor: 3.469
Authors: Gaetano de Donato; Gualberto Gussoni; Gianmarco de Donato; Giuseppe Maria Andreozzi; Erminio Bonizzoni; Antonino Mazzone; Attilio Odero; Giovanni Paroni; Carlo Setacci; Piergiorgio Settembrini; Fabrizio Veglia; Romeo Martini; Francesco Setacci; Domenico Palombo Journal: Ann Surg Date: 2006-08 Impact factor: 12.969
Authors: Zsolt Turóczi; Péter Arányi; Ákos Lukáts; Dávid Garbaisz; Gábor Lotz; László Harsányi; Attila Szijártó Journal: PLoS One Date: 2014-01-13 Impact factor: 3.240
Authors: Gianmarco de Donato; Edoardo Pasqui; Giovanni Giannace; Francesco Setacci; Domenico Benevento; Giancarlo Palasciano; Carlo Setacci Journal: JMIR Res Protoc Date: 2019-03-14
Authors: Florian Simon; Alexander Oberhuber; Nikolaos Floros; Albert Busch; Markus Udo Wagenhäuser; Hubert Schelzig; Mansur Duran Journal: Int J Mol Sci Date: 2018-01-26 Impact factor: 5.923