Preoperative factors influencing the early results of infrainguinal limb salvage procedures

• Published in: Srpski arhiv za celokupno lekarstvo Vol. 135; no. 1-2; pp. 7 - 14
• Main Authors: Cinara, Ilijas S, Davidović, Lazar B, Marković, Miroslav M, Kuzmanović, Ilija B, Koncar, Igor B
• Format: Journal Article
• Language: English; Serbian
• Published: Serbia Serbian Medical Society 01-01-2007
• Subjects: Aged; critical limb ischemia; Female; graft efficacy; graft patency; Humans; Ischemia - surgery; Leg - blood supply; Limb Salvage; Male; Middle Aged; predictive value; Prognosis; Reoperation; Vascular Patency; Vascular Surgical Procedures
• ISSN: 0370-8179; 2406-0895
• DOI: 10.2298/SARH0702007C

The early results of 59 patients treated surgically for critical limb ischemia at the Institute of Cardiovascular Diseases were analyzed. Research was performed in a prospective manner, as an acute study, lasting for three months.
Our focus was on primary and secondary patency rate, and graft efficacy (quality accomplished by graft patency, improvement of clinical status of the leg, and quality of life).
The influence of each variable on the outcome was analyzed (descriptive: sex, comorbidity, risk factors, clinical stage of disease, angiographic verification of pedal arch, previous vascular procedures; and numerical: gender, preoperative Doppler index, angiographic score by Bollinger), as well as their predictive value. Inferential statistics was used for establishing the significance of influence, and univariate regression analysis for predictive values.
No influence of variables on the outcome was evident in the first three months, and their predictive value was not important considering the graft patency rates and efficacy (except for preoperative clinical status affecting the graft efficacy, presence of pedal arch, affecting both primary and secondary patency rates and graft efficacy, and finally Doppler index affecting the secondary patency rates).
When the surgeon needs to give an early prediction of graft destiny, he can rely on preoperative clinical status, earlier vascular operative procedures, presence of pedal arch, and values of Doppler index (in case of reintervention).