Limb Revascularization of Peripheral Artery Disease in the Developing Countries: Earliest 1-Year Experience from Northwestern Nigeria.

Anas Ismail, Abulkadir M Tabari, Kabiru Isyaku, Nafiu Ahmed
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Abstract

Purpose: The purpose of the study is to present the preliminary audit and challenges of earliest cases of balloon angioplasty from Northwestern Nigeria.

Materials and methods: We present our first 25 cases of peripheral angioplasty in Northwestern Nigeria. The clinical diagnosis of peripheral artery disease was confirmed with Doppler ultrasound and angiography. Angioplasty was done either through femoral or brachial artery approaches. The patients were monitored for minimum of 6 months with serial clinical and Doppler ultrasound examinations.

Results: Our patients consist of 19 males and 6 females. Their ages ranged from 20 to 80 years with a mean of 54 ± 17.5 years. There were 13 hypertensive and 15 diabetic patients while 5 patients have co-morbidities of diabetes and Hypertension. Although femoral antegrade route is the common access for angioplasty (14 out of 25), seven patients who were treated through the left brachial artery, six of them had either Type C or D aortoiliac disease in addition to distal lesions. At follow-up, 36% had limb amputation while one patient died a day after the procedure. Out of nine patients who had amputation, six are diabetic.

Conclusion: Although more than half of them had improved blood flow with healing ischemic ulcers and reducing claudications, still substantial number of our patients often present late with severe peripheral artery disease. As a result, we had to resort to cumbersome arterial access and high amputation rate.

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发展中国家外周动脉疾病的肢体血运重建术:尼日利亚西北部最早的1年经验
目的:本研究的目的是介绍尼日利亚西北部最早的球囊血管成形术病例的初步审计和挑战。材料和方法:我们提出了我们的前25例周围血管成形术在尼日利亚西北部。经多普勒超声及血管造影证实外周动脉病变的临床诊断。血管成形术通过股动脉或肱动脉入路进行。通过一系列临床和多普勒超声检查对患者进行至少6个月的监测。结果:本组患者男19例,女6例。年龄20 ~ 80岁,平均54±17.5岁。高血压13例,糖尿病15例,合并糖尿病和高血压5例。虽然股骨顺行是血管成形术的常见途径(25例中有14例),但通过左肱动脉治疗的7例患者中,除远端病变外,其中6例患有C型或D型髂主动脉疾病。在随访中,36%的患者截肢,而一名患者在手术后一天死亡。在9名截肢患者中,有6名是糖尿病患者。结论:虽然超过一半的患者血流改善,缺血性溃疡愈合,跛行减轻,但仍有相当数量的患者经常出现晚期严重的外周动脉疾病。因此,我们不得不求助于繁琐的动脉通路和高截肢率。
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