Surgical Interventions for Acute Limb Ischaemia (ALI).

Zia Ur Rehman, Faisal Sher, Mohammad Hamza Bajwa
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引用次数: 0

Abstract

Objective: To evaluate presentations, aetiologies, interventions, and outcomes of patients presenting with acute limb ischaemia (ALI).

Study design: An observational study. Place and Duration of the Study: Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan, from January 2000 to December 2020.

Methodology: Record of 104 patients who underwent surgical interventions for ALI was retrospectively evaluated. The diagnosis was confirmed on imaging (ultrasound / CTA / conventional angiography). Demographic characteristics, co-morbidities, aetiologies, and outcomes were analysed using descriptive statistics and logistic regression.

Results: The cohort's mean age was 58.89 ± 12.6 years, with (54.8%, n = 57) females and (45.2%, n = 47) males. Hypertension (54.8%, n = 57), diabetes (46.2%, n = 48), and atrial fibrillation (34.6%, n = 36) were common comorbidities. Thromboembolism (67.3%, n = 70) and thrombotic occlusion (32.7%, n = 34) were primary aetiologies, predominantly affecting the lower limb (66.3%, n = 58) and femoral artery (51.9%, n = 54). The majority of cases were classified as Rutherford classification 2A (53.8%; 56 cases) and 2B (44.2%; 46 cases); 58 (55.8%) patients were classified as ASA Class III, while 36 (34.6%) patients were categorised as ASA Class IV. Embolectomy (80.8%, n = 84) was the prevailing intervention, with an amputation rate (17.3%, n = 18) and a mortality rate (5.8%, n = 6).

Conclusion: Most patients with ALI presented with Rutherford Class II and had thromboembolism aetiology. Embolectomy was the most commonly performed procedure with a high amputation rate and mortality.

Key words: Acute limb ischaemia, Embolectomy, Amputation, Thromboembolism.

急性肢体缺血(ALI)的外科干预。
研究目的评估急性肢体缺血(ALI)患者的表现、病因、干预措施和治疗效果:观察性研究。研究地点和时间:巴基斯坦卡拉奇阿迦汗大学医院外科,2000 年 1 月至 2020 年 12 月:方法:回顾性评估104例因ALI接受手术治疗的患者的记录。诊断由影像学(超声/CTA/常规血管造影)证实。采用描述性统计和逻辑回归分析了人口统计学特征、并发症、病因和结果:患者平均年龄为(58.89 ± 12.6)岁,其中女性(54.8%,n = 57),男性(45.2%,n = 47)。高血压(54.8%,n = 57)、糖尿病(46.2%,n = 48)和心房颤动(34.6%,n = 36)是常见的合并症。血栓栓塞(67.3%,n = 70)和血栓闭塞(32.7%,n = 34)是主要病因,主要影响下肢(66.3%,n = 58)和股动脉(51.9%,n = 54)。大多数病例被归类为卢瑟福分类 2A(53.8%;56 例)和 2B(44.2%;46 例);58 例(55.8%)患者被归类为 ASA III 级,36 例(34.6%)患者被归类为 ASA IV 级。栓子切除术(80.8%,n = 84)是最主要的干预措施,截肢率(17.3%,n = 18)和死亡率(5.8%,n = 6):结论:大多数 ALI 患者为卢瑟福 II 级,病因为血栓栓塞。栓塞切除术是最常见的手术,截肢率和死亡率都很高:急性肢体缺血、栓塞切除术、截肢、血栓栓塞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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