Conservative Treatment in Selected Patients with Severe Critical Limb Ischemia.
World J Surg
; 39(8): 2090-5, 2015 Aug.
Article
en En
| MEDLINE
| ID: mdl-25894404
OBJECTIVE: To assess the outcome of conservative treatment of severe critical limb ischemia (CLI) classified as Rutherford 5/6. BACKGROUND: The preferred therapy for CLI is either endovascular revascularization or bypass surgery. With a growing aged population with more serious comorbidities, these therapies are not always a viable option. Primary amputation leads to decreased mobility and a reduced quality of life. There is a lack of literature regarding the outcome of conservative therapy. METHODS: Hospital charts were reviewed of all patients who were diagnosed with Rutherford classification 5-6 and received conservative treatment and lacked interventional options. Outcome measures were mortality, complete wound closure, and limb salvage rate. RESULTS: 38 patients were included with a median age of 80 years (range 57-97). The amputation rate during follow-up was 16%. In 58% of patients, complete wound closure was achieved. All-cause mortality was 58% with a 2-year survivability rate of 55%. CONCLUSIONS: Conservative management in our selected patients with CLI results in a moderate rate of wound closure and acceptable amputation rates albeit with a high mortality rate. For patients not eligible for endovascular revascularization or bypass surgery, conservative treatment could be a viable option besides primary limb amputation.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Extremidad Inferior
/
Enfermedad Arterial Periférica
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Manejo del Dolor
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Gangrena
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Amputación Quirúrgica
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Isquemia
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Úlcera de la Pierna
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Antibacterianos
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World J Surg
Año:
2015
Tipo del documento:
Article
Pais de publicación:
Estados Unidos