Medicina (Kaunas) 2003; 39 (7): 646-653

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The surgical treatment of the lower limb acute ischemia*

Aleksandras Antuševas, Nerijus Aleksynas

Department of Vascular Surgery, Kaunas University of Medicine Hospital, Lithuania

Key words: embolism, acute thrombosis, operations, the early results of surgical treatment, total death-rate.

Summary. Objective. To analyze the surgical treatment strategy of lower limb acute ischemia and its results in the Department of Vascular Surgery of Kaunas University of Medicine Hospital in the period from 1999 to 2001.

Material and methods. While collecting the data retrospectively there has been determined, that due to the acute ischemia of the limbs there have been operated 244 patients (12.2% of all treated arterial patients). Because of the lower limb acute ischemia there have been operated 142 (7.1%) patients. All embolism and thrombosis have been approved with the operation findings. The comparison of quantitative values was done according to the Student parameter.

Results. The acute ischemia in the leg has been caused by: embolism – for 76 (53.5%) patients, acute thrombosis – for 66 (46.5%). Heart diseases have been ascertained in embolism group for 22.4% of patients, in acute thrombosis group – for 6.1%. The localities of embolism – the popliteal artery for 44.7% and femoral artery for 32.9%, acute thrombosis – in the femoral artery for 37.9% and iliac artery for 22.7%. Men experience the acute thrombosis more often (3.5:1), p<0.0001, and women – embolism (2.5:1), p<0.0001. Embolism has been treated with embolectomy, and acute thrombosis with thrombectomy, thrombendarterectomy and the bypass operations. There have been made 4.9% of great amputations, rescued 96.1% of lower limbs with the features of acute ischemia. Total death rate – 4.2%.

Conclusions. The acute ischemia in the leg because of embolism was for 76 patients, the acute thrombosis – for 66 patients. Lower limbs embolism of arteries is more common for women, p<0.0001, acute thrombosis for men, p<0.0001. The death rate is higher in women group with acute ischemia than men, (p=0.1198) and in men group with acute ischemia in the lower limb there are made more great amputations (p=0.04250).

Correspondence to N. Aleksynas, Department of Vascular Surgery, Kaunas University of Medicine Hospital, Eivenių 2, 3007 Kaunas, Lithuania. E-mail: nalex@takas.lt

Received 1 April 2003, accepted 16 May 2003