Is revascularization and limb salvage always the treatment for critical limb ischemia?

Journal of Cardiovascular Surgery

Volumn 45, Issue 3, 2004, Pages 177-184

  Nehler, Mark R ^a,b   Peyton, B D ^a  

^a UNIVERSITY OF COLORADO   (United States)

^b UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

Author keywords

Arterial occlusive disease, therapy; Ischemia; Leg

Indexed keywords

AGING; ALGORITHM; CLINICAL FEATURE; DIAGNOSTIC PROCEDURE; DISEASE SEVERITY; EDITORIAL; FUNCTIONAL ASSESSMENT; HIGH RISK PATIENT; HUMAN; LEG AMPUTATION; LEG REVASCULARIZATION; LIFE EXPECTANCY; LIMB ISCHEMIA; LIMB SALVAGE; MEDICAL CARE; MEDICAL DECISION MAKING; MORBIDITY; OUTCOMES RESEARCH; PATIENT CARE; PERIPHERAL OCCLUSIVE ARTERY DISEASE; REVASCULARIZATION; RISK FACTOR; SURGICAL MORTALITY; SURGICAL RISK; SURGICAL TECHNIQUE; SURVIVAL; SYSTEMIC DISEASE; TREATMENT INDICATION; AGE; AGED; CHRONIC DISEASE; COMPARATIVE STUDY; CRITICAL ILLNESS; FEMALE; HOSPITALIZATION; ISCHEMIA; LEG; MALE; METHODOLOGY; MIDDLE AGED; MORTALITY; PERIPHERAL VASCULAR DISEASE; PROGNOSIS; RISK ASSESSMENT; VASCULAR SURGERY; VASCULARIZATION;

AGE FACTORS; AGED; AGED, 80 AND OVER; ARTERIAL OCCLUSIVE DISEASES; CHRONIC DISEASE; CRITICAL ILLNESS; FEMALE; HUMANS; ISCHEMIA; LIMB SALVAGE; LOWER EXTREMITY; MALE; MIDDLE AGED; PERIPHERAL VASCULAR DISEASES; PROGNOSIS; RISK ASSESSMENT; SEVERITY OF ILLNESS INDEX; SURVIVAL ANALYSIS; VASCULAR SURGICAL PROCEDURES;

EID: 4043061502     PISSN: 00219509     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Editorial

References (71)

1. Feinglass J, Brown JL, LoSasso A, Sohn MW, Manheim LM, Shah SJ et al. Rates of lower-extremity amputation and arterial reconstruction in the United States, 1979 to 1996. Am J Public Health 1999; 89:1222-7.
2. Connelly J, Airey M, Chell S. Variation in clinical decision making is a partial explanation for geographical variation in lower extremity amputation rates. Br J Surg 2001;88:529-35.
3. Dormandy J, Heeck L, Vig S. The natural history of claudication: risk to life and limb. Semin Vasc Surg 1999;12:123-37.
4. Dormandy JA, Murray GD. The fate of the claudicant: a prospective study of 1969 claudicants. Eur J Vasc Surg 1991;5:131-3.
5. Muluk SC, Muluk VS, Kelley ME, Whittle JC, Tierney JA, Webster MW et al. Outcome events in patients with claudication: a 15-year study in 2777 patients. J Vasc Surg 2001;33:251-7.
6. Dormandy J, Belcher G, Broos P, Eikelboom B, Laszlo G, Konrad P et al. Prospective study of 713 below-knee amputations for ischaemia and the effect of a prostacyclin analogue on healing. Hawaii Study Group. Br J Surg 1994;81:33-7.
7. McDermott MM, Mehta S, Greenland P. Exertional leg symptoms other than intermittent claudication are common in peripheral arterial disease. Arch Intern Med 1999;159:387-92.
8. McDermott MM, Fried L, Simonsick E, Ling S, Guralnik JM. Asymptomatic peripheral arterial disease is independently associated with impaired lower extremity functioning: the women's health and aging study. Circulation 2000;101:1007-12.
9. McDermott MM, Greenland P, Liu K, Guralnik JM, Criqui MH, Dolan NC et al. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA 2001;286:1599-606.
10. Nehler MR, Coll JR, Hiatt WR, Regensteiner JG, Schnickel GT, Klenke WA et al. Functional outcome in a contemporary series of major lower extremity amputations. J Vasc Surg 2003;38:7-14.
11. Nicoloff AD, Taylor LM Jr, McLafferty RB, Moneta GL, Porter JM. Patient recovery after infrainguinal bypass grafting for limb salvage. J Vasc Surg 1998;27:256-63.
12. Nehler MR, Moneta GL, Edwards JM, Yeager RA, Taylor LM Jr, Porter JM. Surgery for chronic lower extremity ischemia in patients eighty or more years of age: operative results and assessment of postoperative independence. J Vasc Surg 1993;18:618-24.
13. Abou-Zamzam AM Jr, Lee RW, Moneta GL, Taylor LM Jr, Porter JM. Functional outcome after infrainguinal bypass for limb salvage. J Vasc Surg 1997;25:287-95.
14. Pomposelli FB Jr, Arora S, Gibbons GW, Frykberg R, Smakowski P, Campbell DR et al. Lower extremity arterial reconstruction in the very elderly: successful outcome preserves not only the limb but also residential status and ambulatory function. J Vasc Surg 1998; 28:215-25.
15. Seabrook GR, Cambria RA, Freischlag JA, Towne JB. Health-related quality of life and functional outcome following arterial reconstruction for limb salvage. Cardiovasc Surg 1999;7:279-86.
16. Albers M, Fratezi AC, De Luccia N. Assessment of quality of life of patients with severe ischemia as a result of infrainguinal arterial occlusive disease. J Vasc Surg 1992;16:54-9.
17. Duggan MM, Woodson J, Scott TE, Ortega AN, Menzonian JO. Functional outcome in limb salvage vascular surgery. Am J Surg 1994;168:188-191.
18. Gibbons GW, Burgess AM, Guadagnoli E, Pomposelli FB, Freeman DV, Campbell DR et al. Return to well-being and function after infrainguinal revascularization. J Vasc Surg 1995;21:35-45.
19. Johnson BF, Evans L, Drury R, Datta D, Morris-Jones W, Beard JD. Surgery for limb threatening ischaemia: a reappraisal of the costs and benefits. Eur J Vasc Endovasc 1995;9:181-8.
20. Paaske WP, Laustsen J. Femorodistal bypass grafting: quality of life and socioeconomic aspects. Eur J Vasc Endovasc Surg 1995;10: 226-30.
21. Albers M, Fratezi AC, De Luccia N. Walking ability and quality of life as outcome measures in a comparison of arterial reconstruction and leg amputation for the treatment of vascular disease. Eur J Vasc Endovasc Surg 1996;11:308-14.
22. Johnson BE, Singh S, Evans L, Drury R, Datta D, Beard JD. A prospective study of the effect of limb-threatening ischaemia and its surgical treatment on the quality of life. Eur J Vasc Endovasc Surg 1997;13:306-14.
23. Chetter IC, Spark JI, Scott DJ, Kent PJ, Berridge DC, Kester RC. Prospective analysis of quality of life in patients following infrainguinal reconstruction for chronic critical ischaemia. Br J Surg 1998; 85:951-5.
24. Klevsgard R, Hallberg IR, Risberg B, Thomsen MB. The effects of successful intervention on quality of life in patients with varying degrees of lower-limb ischaemia. Eur J Vasc Endovasc Surg 2000; 19:238-45.
25. Klevsgard R, Risberg BO, Thomsen MB, Hallberg IR. A 1-year follow-up quality of life study after hemodynamically successful or unsuccessful surgical revascularization of lower limb ischemia. J Vasc Surg 2001;33:114-22.
26. Tretinyak AS, Lee ES, Kuskowski MM, Caldwell MP, Santilli SM. Revascularization and quality of life for patients with limb-threatening ischemia. Ann Vasc Surg 2001;15:84-8.
27. Gardner AW, Killewich LA. Lack of functional benefits following infrainguinal bypass in peripheral arterial occlusive disease patients. Vasc Med 2001;6:9-14.
28. Nehler MR, McDermott MM, Treat-Jacobson D, Chetter I, Regensteiner JG. Functional outcomes and quality of life in peripheral arterial disease: current status. Vasc Med 2003;8:115-26.
29. Feinglass J, Pearce WH, Martin GJ, Gibbs J, Cowper D, Sorensen M et al. Postoperative and amputation-free survival outcomes after femorodistal bypass grafting surgery: findings from the Department of Veterans Affairs National Surgical Quality Improvement Program. J Vasc Surg 2001;34:283-90
30. Feinglass J, Pearce WH, Martin GJ, Gibbs J, Cowper D, Sorensen M et al. Postoperative and late survival outcomes after major amputation: findings from the Department of Veterans Affairs National Surgical Quality Improvement Program. Surgery 2001; 130:21-9.
31. Taylor LM Jr, Hamre D, Dalman RL, Porter JM. Limb salvage vs amputation for critical ischemia. The role of vascular surgery. Arch Surg 1991;126:1251-7.
32. Ouriel K, Fiore WM, Geary JE. Limb-threatening ischemia in the medically compromised patient: amputation or revascularization? Surgery 1988;104:667-72.
33. Treiman GS, Copland S, Yellin AE, Lawrence PF, McNamara RM, Treiman RL. Wound infections involving infrainguinal autogenous vein grafts: a current evaluation of factors determining successful graft preservation. J Vasc Surg 2001;33:948-54.
34. Kikta MJ, Goodson SF, Bishara RA, Meyer JP, Schuler JJ, Flanigan DP. Mortality and limb loss with infected infrainguinal bypass grafts. J Vasc Surg 1987;5:566-71.
35. Reilly LM, Altman H, Lusby RJ, Kersh RA, Ehrenfeld WK, Stoney RJ. Late results following surgical management of vascular graft infection. J Vasc Surg 1984;1:36-44.
36. Samson RH, Veith FJ, Janko GS, Gupta SK, Scher IA. A modified classification and approach to the management of infections involving peripheral arterial prosthetic grafts. J Vasc Surg 1988;8:147-53.
37. Panayiotopoulos YP, Reidy JF, Taylor PR. The concept of knee salvage: why does a failed femorocrural/pedal arterial bypass not affect the amputation level? Eur J Vasc Endovasc Surg 1997;13:477-85.
38. Tsang GM, Crowson MC, Hickey NC, Simms MH. Failed femorocrural reconstruction does not prejudice amputation level. Br J Surg 1991;78:1479-81.
39. Cook TA, Davies AH, Horrocks M, Baird RN. Amputation level is not adversely affected by previous femorodistal bypass surgery. Eur J Vasc Surg 1992;6:599-601.
40. Van Niekerk LJ, Stewart CP, Jain AS. Major lower limb amputation following failed infrainguinal vascular bypass Surgery: a prospective study on amputation levels and stump complications. Prosthet Orthot Int 2001;25:29-33.
41. Dardik H, Kahn M, Dardik I, Sussman B, Ibrahim IM. Influence of failed vascular bypass procedures on conversion of below-knee to above-knee amputation levels. Surgery 1982;91:64-9.
42. Epstein SB, Worth MH Jr, el Ferzli G. Level of amputation following failed vascular reconstruction for lower limb ischemia. Curr Surg 1989;46:185-92.
43. Rubin JR, Marmen C, Rhodes RS. Management of failed prosthetic grafts at the time of major lower extremity amputation. J Vasc Surg 1988;7:673-6.
44. Houghton AD, Taylor PR, Thurlow S, Rootes E, McColl I. Success rates for rehabilitation of vascular amputees: implications for preoperative assessment and amputation level. Br J Surg 1992;79: 753-5.
45. Nehler MR, Hiatt WR, Taylor LM Jr. Is revascularization and limb salvage always the best treatment for critical limb ischemia? J Vasc Surg 2003;37:704-8.
46. Johnson BL, Glickman MH, Bandyk DF, Esses GE. Failure of foot salvage in patients with end-stage renal disease after surgical revascularization. J Vasc Surg 1995;22:280-5.
47. Sanchez LA, Goldsmith J, Rivers SP, Panetta TF, Wengerter KR, Veith FJ. Limb salvage surgery in end stage renal disease: is it worthwhile? J Cardiovasc Surg (Torino) 1992;33:344-8.
48. Baele HR, Piotrowski JJ, Yuhas J, Anderson C, Alexander JJ. Infrainguinal bypass in patients with end-stage renal disease. Surgery 1995;117:319-24.
49. Meyerson SL, Skelly CL, Curi MA, Desai TR, Katz D, Bassiouny HS et al. Long-term results justify autogenous infrainguinal bypass grafting in patients with end-stage renal failure. J Vasc Surg 2001; 34:27-33.
50. Harpavat M, Gahtan V, Ierardi R, Kerstem MD, Roberts AB. Does renal failure influence-infrainguinal bypass graft outcome? Am Surg 1998;64:155-9.
51. Levy PJ, Gonzalez ME, Hornung CA, Chang WW, Haynes JL, Rush DS. A prospective evaluation of atherosclerotic risk factors and hypercoagulability in young adults with premature lower extremity atherosclerosis. J Vasc Surg 1996;23:36-43, discussion 43-5.
52. Valentine RJ, Kaplan HS, Green R, Jacobsen DW, Myers SI, Clagett GP. Lipoprotein (a), homocysteine, and hypercoagulable states in young men with premature peripheral atherosclerosis: a prospective, controlled analysis. J Vasc Surg 1996;23:53-61, discussion 61-3.
53. Levy PJ. Premature lower extremity atherosclerosis: clinical aspects. Am J Med Sci 2002;323:11-6.
54. Valentine RJ, Jackson MR, Modrall JG, McIntyre KE, Clagett GP. The progressive nature of peripheral arterial disease in young adults: a prospective analysis of white men referred to a vascular surgery service. J Vasc Surg 1999;30:436-44.
55. Valentine RJ, Myers SI, Inman MH, Roberts JR, Clagett GP. Late outcome of amputees with premature atherosclerosis. Surgery 1996; 119:487-93.
56. Friedman SG, Kerner BA, Friedman MS, Moccio CG. Limb salvage in elderly patients. Is aggressive surgical therapy warranted? J Cardiovasc Surg (Torino) 1989;30:848-51.
57. Scher LA, Veith FJ, Ascer E, White RA, Samson RH, Sprayregen S et al. Limb salvage in octogenarians and nonagenarians. Surgery 1986;99:160-5.
58. O'Mara CS, Kilgore TL Jr, McMullan MH, Maples MD, Hollingsworth JF, Tyler HB. Distal bypass for limb salvage in very elderly patients. Am Surg 1987;53:66-70.
59. Chang BB, Bock DE, Jacobs RL, Darling RC, III, Leather RP, Shah DM. Increased limb salvage by the use of unconventional foot amputations. J Vasc Surg 1994;19:341-8.
60. Gooden MA, Gentile AT, Mills JL, Berman SS, Demas CP, Reinke KR et al. Free tissue transfer to extend the limits of limb salvage for lower extremity tissue loss. Am J Surg 1997;174:644-8.
61. Quinones-Baldrich WJ, Kashyap VS, Taw MB, Markowitz BL, Watson JP, Reil TD et al. Combined revascularization and microvascular free tissue transfer for limb salvage: a six-year experience. Ann Vasc Surg 2000;14:99-104.
62. Fisher RK, Kirkpatrick UJ, How TV, Brennan JA, Gilling-Smith GL, Harris PL. The distaflo graft: a valid alternative to interposition vein? Eur J Vasc Endovasc Surg 2003;25:235-9.
63. Neville RF, Tempesta B, Sidway AN. Tibial bypass for limb salvage using polytetrafluoroethylene and a distal vein patch. J Vasc Surg 2001;33:266-71.
64. Pappas PJ, Hobson RW, Meyers MG, Jamil Z, Lee BC, Silva MB Jr et al. Patency of infrainguinal polytetrafluoroethylene bypass grafts with distal interposition vein cuffs. Cardiovasc Surg 1998;6:19-26.
65. Stonebridge PA, Prescott RJ, Ruckley CV. Randomized trial comparing infrainguinal polytetrafluoroethylene bypass grafting with and without vein interposition cuff at the distal anastomosis. The Joint Vascular Research Group. J Vasc Surg 1997;26:543-50.
66. Yeung KK, Mills JL Sr, Hughes JD, Berman SS, Gentile AT, Westerband A. Improved patency of infrainguinal polytetrafluoroethylene bypass grafts using a distal Taylor vein patch. Am J Surg 2001;182:578-83.
67. Biancari F, Kantonen I, Alback A, Matzke S, Luther M, Lepantalo M. Limits of infrapopliteal bypass surgery for critical leg ischemia: when not to reconstruct. World J Surg 2000;24:727-33.
68. Matzke S, Biancari F, Ihlberg L, Alback A, Kantonen I, Railo M et al. Increased preoperative c-reactive protein level as a prognostic factor for postoperative amputation after femoropopliteal bypass surgery for CLI. Ann Chir Gynaecol 2001;90:19-22.
69. Delgado-Rodriguez M, Medina-Cuadros M, Gomez-Ortega A, Martinez-Gallego G, Mariscal-Ortiz M, Martinez-Gonzalez MA et al. Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay. Arch Surg 2002;137:805-12.
70. Herrmann FR, Safran C, Levkoff SE, Minaker KL. Serum albumin level on admission as a predictor of death, length of stay, and readmission. Arch Intern Med 1992;152:125-30.
71. Marinella MA, Markert R.J. Admission serum albumin level and length of hospitalization in elderly patients. South Med J 1998; 91:851-4.