doiSerbia

Preoperative factors influencing the early results of infrainguinal limb salvage procedures

Činara Ilija S. (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Davidović Lazar B. (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Marković Miroslav M. (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Kuzmanović Ilija B. (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Končar Igor B. (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)

Introduction: 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. Objective 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). Method 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. Results 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). Conclusion 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).

Keywords: critical limb ischemia, graft patency, graft efficacy, predictive value