Wahlberg E, Lepner U, Olofsson P
Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
Eur J Surg. 1994 Oct;160(10):561-7.
To evaluate the type, timing and number of vascular reconstructions that preceded amputation; to compare the characteristics of amputees who had had reconstructions with those of amputees who had not, and to compare the results of amputation.
Retrospective study of case notes.
University hospital, Sweden.
All 219 patients who underwent amputation between 1987 and 1992.
Incidence of amputations; presenting features, and type and results of vascular reconstructions.
The number of amputations decreased after 1988, and that of vascular reconstructions increased. 56 of the 99 who had amputations after reconstruction (57%) had had their last procedure within a month. This group had had a mean of three operations, had worse run-off as assessed by angiography, and 2 of them (5%) had amputations after failed suprainguinal reconstruction for claudication alone. 68 of the total (31%) had amputations without first being assessed by a vascular surgeon. 52 (24%) required reamputation.
Better objective methods are needed for the assessment of patients before primary as well as secondary vascular reconstructions. All patients should be seen by a vascular surgeon before amputation is recommended.
