TREATMENT AND OUTCOME OF SEVERE LOWER-LIMB ISCHEMIA

The overall outcome of severe lower-limb ischaemia in terms of limb sa lvage and mortality is poorly documented. A consecutive series of 232 severely ischaemic legs in 209 patients was therefore studied. An aggr essive policy of revascularization has been pursued; this was attempte d in 89 per cent of legs, with a primary amputation rate of 8 per cent . The perioperative 30-day limb salvage rate was 79 per cent with a pa tient mortality rate of 20 per cent. At 12 and 24 months the limb salv age rates were 74 and 71 per cent and patient survival rates 75 and 73 per cent respectively. To identify high-risk groups the effects on li mb salvage and mortality of age, sex, presentation, diabetes and ankle systolic pressure of 50 mmHg or less were studied. Using life-table a nalysis, none of the preoperative risk factors had an effect on limb s alvage and mortality. An aggressive policy of revascularization provid es excellent results in the treatment of patients with severe leg isch aemia.