Document Detail


Impact of endovascular surgery on management of critical lower-limb ischemia in a vascular surgery department.
MedLine Citation:
PMID:  16193216     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors analyzed the impact of introduction of endovascular techniques on management and evolution of critical ischemia (CI) in an Angiology and Vascular Surgery department. This is a retrospective review of patients admitted for CI during 2 2-year periods (A: January 1997-December 1998 and B: January 2000-December 2001) differentiated by introduction of endovascular techniques in 1999. Demographic data, clinical symptoms, treatment used, and evolution were recorded and compared between the 2 periods. Survival and limb salvage were analyzed by life tables and compared by log-rank test. One hundred and ninety-three admissions (limbs) for CI were recorded in period A and 226 admissions (limbs) in period B, with no differences in terms of age, sex, clinical severity, or region affected. The distribution of the treatments used in groups A, B, and group B with exclusion of endovascular techniques (B*), was as follows: revascularization (A: 67.4%; B: 50%; B*: 65%); endovascular (A: 0%; B: 23%; B*: 0%); primary amputation (A: 11.4%; B: 11.1%; B*: 14%); conservative (A: 21.2%; B: 15.9%; B*: 21%). Excluding the endovascular procedures, there were no differences between periods as regards the type of treatment or the surgical technique used. There were no differences in early mortality or complication rates. Long-term survival was significantly better in periods B and B* than in period A (p < 0.01). Insignificant improvement in limb salvage was observed in period B (A 74% vs B 82.5%; 12 months). Endovascular procedures extend the therapeutic arsenal, but they do not change management and evolution of CI. Improved survival observed in period B is maintained when endovascular procedures are excluded (period B*), so cannot be attributed only to endovascular techniques.
Authors:
A F Heredero; Francisco Acín; J R March; F Utrilla
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  39     ISSN:  1538-5744     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-09-29     Completed Date:  2006-08-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  429-35     Citation Subset:  IM    
Affiliation:
Department of Angiology and Vascular Surgery, Hospital Universitario de Getafe, Madrid, Spain. afheredero@mi.madritel.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Femoral Artery / pathology,  surgery
Follow-Up Studies
Humans
Ischemia / surgery*
Lower Extremity / blood supply*,  pathology,  surgery*
Male
Popliteal Artery / pathology,  surgery
Retrospective Studies
Risk Factors
Severity of Illness Index
Surgery Department, Hospital
Survival Analysis
Treatment Outcome
Vascular Surgical Procedures* / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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