Characterization of infrainguinal arterial surgery in patients with critical lower limb ischemia

Abstract

Introduction: Critical ischemia of the lower limbs is the last stage of a process with a very unfavorable prognosis, both for the limb and for survival. 50 % of these patients end up in major amputation. Annual mortality is 20 %.

Objective: To characterize infrainguinal arterial surgery in critical ischemia of the lower limbs.

Methods: Descriptive, longitudinal and prospective study of patients who underwent infrainguinal surgery for critical ischemia of the lower limbs between January 2017 and January 2020. The sample consisted of 73 patients. The variables studied were age, sex, risk factors, Fontaine classification, surgical techniques, location of anastomosis, behavior, types of grafts, complications, limb salvage rate, and mortality.

Results: It was found that 82.1 % were over 60 years of age, and that 60.2 % were men. The most common risk factors were hypertension (73.9 %) and diabetes (63 %). Stage iv was the most common (56.1 %), the most commonly performed surgeries were femoropopliteal bypass (42.4 %), common femoral artery anastomosis (73.4 %) and proximal popliteal artery (17.6 %). The autologous vein stood out as the most used (60 %), and thrombosis was the most common complication (56 %). The salvage rate was 61.6 %; and mortality of 6.8 % at the sixth month.

Conclusions: Men over 60 years with risk factors are more likely to suffer from critical lower limb ischemia. A favorable outcome was obtained in most cases, with a low overall surgical fatality rate.