Lb. Ebskov et al., Level of amputation following failed arterial reconstruction compared to primary amputation - a meta-analysis, EUR J VAS E, 17(1), 1999, pp. 35-40
Citations number
45
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Objectives: to determine if the level of amputation after failed vascular r
econstruction was comparable to the level of amputation after primary amput
ation.
Design and methods: medline literature search (1975-1996), meta-analysis.
Results: the odds ratio of transtibial to transfemoral (TT/TF) amputations
was 927/657 = 1.41 (95% confidence limits: 1.278-1.561) in postrevascularis
ation amputation (PRVA) and 1590/1162 = 1.37 (95% confidence limits: 1.269-
1.477) in primary amputation (PA) (p = 0.65). The pooled data show that the
number of conversion from transtibial (TT) to transfemoral (TF) amputation
s due to amputation stump complications were 85/369 (23%) in PRVA against 9
3/752 (12.4%) in PA (p<0.01).
Conclusions: we could not detect any difference in TT/TF ratio between PRVA
and PA. However, the risk of conversion i.e. reamputation to a higher leve
l is higher after PRVA compared to PA. The chance of having a successful tr
anstibial amputation is approximately 58% for postrevacularisation amputati
on as well as for primary amputations, An aggressive approach towards vascu
lar reconstruction seems justified.