Limb salvage in critical ischaemia

ABSTRACT

125 patients with critical limb threating ischaemia are reviewed. The majority were male smokers. 92% involved the lower extremity. Thirty primary amputations were done as these presented with fixed and extensive gangrene with an operative mortality of 36.8%. 23% had acute onset of ischaemia while 77% presented with chronic ischaemia. Thromboembolectomy salvaged 80% of the acute ischaemia cases. The chronic ischaemia groups was predominantly secondary to atherosclerotic arterial occlusive disease and not Thrombo Angitis obliterans contrary to the local belief. Femeropopliteal [13] was the most common bypass procedure performed. Aorto-Bilateral femoral [4], popliteo tibial [4] and extra anatomic bypasses [4] were the next common procedures. Overall in the bypass procedures there was 88% immediate graft patency and 84% limb salvage. Aggressive attempts towards limb salvage is recommended