Kazmi Tehreem, Soomro Faiza H, Ansar Mehwish
General Surgery, Shifa International Hospital Islamabad, Islamabad, PAK.
General Surgery, The Dudley Group NHS Foundation Trust, Dudley, GBR.
Cureus. 2022 Aug 11;14(8):e27900. doi: 10.7759/cureus.27900. eCollection 2022 Aug.
The study aimed to determine the frequency of successful limb salvage in patients presenting with critical limb ischemia utilizing the available revascularization modalities. This descriptive cross-sectional study was conducted in the Department of General Surgery, Shifa International Hospital, Islamabad, from April 2017 to August 2017.
A total of 96 patients with critical limb ischemia requiring urgent surgery for limb salvage were included in our study. Patients who had undergone previous surgeries for limb ischemia involving the same limb, had concurrent venous disease, or suffered from acute limb ischemia were excluded. All patients underwent either endoscopic angioplasty or bypass surgery. All patients were followed up for six months for the success of limb salvage and the requirement for amputation. Data were analyzed by SPSS version 26.0 (Armonk, NY: IBM Corp.).
Our patients had a mean age of 62.03±8.46 years, of whom 63 (65.6%) were men. A total of 47 (49.0%) patients required surgery for a non-healing ulcer, while 49 (51.0%) had resting leg pain. In 55 (57.3%) patients, bypass surgery was performed, while 35 (36.5%) underwent endoscopic angioplasty. The remaining six (6.2%) patients received a combination of both procedures. Limb salvage was successful in 78 (81.3%) patients. There was no difference between outcomes across gender (p=0.122), nor was there any difference in outcome between bypass surgery and endoscopic angioplasty (p=0.665).
Encouraging results can be obtained in treatment of critical limb ischemia if revascularization techniques are utilized prudently in a time-effective manner and individualized to each patient's requirements.
本研究旨在确定采用现有血管重建方式治疗严重肢体缺血患者时肢体挽救成功的频率。这项描述性横断面研究于2017年4月至2017年8月在伊斯兰堡希法国际医院普通外科进行。
本研究共纳入96例需要紧急手术以挽救肢体的严重肢体缺血患者。排除既往曾对同一肢体进行过肢体缺血手术、合并静脉疾病或患有急性肢体缺血的患者。所有患者均接受了内镜血管成形术或搭桥手术。所有患者均随访6个月，以评估肢体挽救的成功率和截肢需求。数据采用SPSS 26.0版（纽约州阿蒙克：IBM公司）进行分析。
我们的患者平均年龄为62.03±8.46岁，其中63例（65.6%）为男性。共有47例（49.0%）患者因溃疡不愈合需要手术，而49例（51.0%）患者有静息性腿痛。55例（57.3%）患者接受了搭桥手术，35例（36.5%）接受了内镜血管成形术。其余6例（6.2%）患者接受了两种手术的联合治疗。78例（81.3%）患者肢体挽救成功。不同性别之间的结果无差异（p=0.122），搭桥手术和内镜血管成形术之间的结果也无差异（p=0.665）。
如果以时间有效的方式谨慎使用血管重建技术并根据每个患者的需求进行个体化治疗，在治疗严重肢体缺血方面可以获得令人鼓舞的结果。
