Do patients with critical limb ischaemia undergo multiple amputations after infrainguinal bypass surgery?

Background: it has been suggested that an aggressive policy of bypass for l imb salvage in critical ischaemia may result in patients subsequently under going multiple amputations. The aim of this study was to test this suggesti on in the context of a dedicated Vascular Surgical Unit in a U.K, teaching hospital. Methods: three hundred and sixty-eight patients undergoing lower limb bypas s operations for critical limb ischaemia between April 1991 and March 1999 were studied retrospectively. Their median age was 69 years (IQR 64-75) and 243 (66%) were men. Results: seventy-five operations were followed by one or more amputation (2 0%). Only 2% were multiple amputations. Age and sex had no effect on amputa tion rates, but emergency bypass operations led to a higher rate of amputat ion in those with critical limb ischaemia. Conclusion: patients with critical limb ischaemia who undergo lower limb by pass surgery rarely have subsequent multiple amputation.