Umetsu Michihisa, Akamatsu Daijirou, Goto Hitoshi, Ohara Masato, Hashimoto Munetaka, Shimizu Takuya, Sugawara Hirofumi, Tsuchida Ken, Yoshida Yoshitaro, Tajima Yuta, Suzuki Shunya, Horii Shinichiro, Watanabe Tetsuo, Miyagi Shigehito, Unno Michiaki, Kamei Takashi
Division of Vascular Surgery, Department of Surgery, Tohoku University Hospital, Sendai, Miyagi, Japan.
Department of Surgery, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan.
Ann Vasc Dis. 2019 Sep 25;12(3):347-353. doi: 10.3400/avd.oa.19-00018.
: To examine the medium- to long-term outcomes of acute limb ischemia (ALI), which are unclear at present. : We analyzed 93 consecutive limbs in 77 patients with ALI between January 2005 and December 2015 treated at our vascular center. We categorized the cases into four groups according to etiology (embolism, thrombosis, graft thrombosis, and dissection groups) to assess survival, limb salvage, and freedom from re-intervention rates. : The mean age at onset was 72±15 years. The median follow-up length was 2.90 years. The Rutherford categories I, IIa, IIb, and III included 1, 38, 51, and 3 cases, respectively. Thromboembolectomy was performed in all patients in the embolism and thrombosis groups. In addition, endovascular treatment was performed in 25 (37.3%) patients, especially in the thrombosis group (81.3%). A major amputation could not be avoided in 10 patients. The 5-year limb salvage rates for categories IIa and IIb were 97.1% and 83.1%, respectively. The 5-year freedom from re-intervention rate was 89.2%. The survival rates at 1, 3, and 5 years were 87.9%, 75.2%, and 60.6%, respectively. : The 5-year survival rates of patients with ALI were equivalent to those with chronic limb threatening ischemia (CLTI). The intervention and long-term outcomes were distinguishable according to etiology.
研究急性肢体缺血（ALI）的中长期预后情况，目前该情况尚不清楚。
我们分析了2005年1月至2015年12月期间在我们血管中心接受治疗的77例ALI患者的93条连续肢体。我们根据病因将病例分为四组（栓塞、血栓形成、移植物血栓形成和夹层组），以评估生存率、肢体挽救率和免于再次干预率。
发病时的平均年龄为72±15岁。中位随访时间为2.90年。Rutherford分级I、IIa、IIb和III级分别包括1例、38例、51例和3例。栓塞组和血栓形成组的所有患者均接受了血栓切除术。此外，25例（37.3%）患者接受了血管内治疗，尤其是在血栓形成组（81.3%）。10例患者无法避免大截肢。IIa级和IIb级的5年肢体挽救率分别为97.1%和83.1%。5年免于再次干预率为89.2%。1年、3年和5年的生存率分别为87.9%、75.2%和60.6%。
ALI患者的5年生存率与慢性肢体威胁性缺血（CLTI）患者相当。根据病因，干预措施和长期预后有所不同。
