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Controversy exists as to whether the level of amputation is adversely affected by an unsuccessful limb salvage attempt. Two hundred ten amputations following failed reconstruction attempts in 191 patients were studied and compared with 551 amputations in limbs with no prior revascularization. Initially, 147 of those with failed reconstruction attempts underwent below-knee (BK) amputation and 63 underwent above-knee (AK) amputation. One hundred ten of 143 (77%) surviving BK amputations eventually healed. This is in contrast to the eventual healing in 266 of 298 (89%) of the BK amputations performed with no prior attempts at reconstruction. A statistically significant (p<0.05) difference in eventual healing favoring those with no prior reconstruction was demonstrated. Successful reconstruction of the ischemic extremity is the goal of vascular surgery and should be attempted when indicated. However, it should be realized that unsuccessful revascularization attempts may adversely affect healing in those limbs initially considered for a BK amputation.
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- Amputation level following unsuccessful distal limb salvage operations.Surgery. 1980; 87: 683-687
- Predictive value of ultrasonically derived arterial pressure in determination of amputation level.Am Surg. 1975; 41: 731-737
- An index of healing in below-knee amputation; leg blood pressure by doppler ultrasound.Surgery. 1976; 7: 913-920
- Major lower extremity amputations following arterial reconstruction.Arch Surg. 1974; 108: 655-660
- Level of amputation after failure of limb salvage procedure.Surg Gynecol Obstet. 1982; 154: 56-58
- Femoropopliteal tibial bypass: what price failure?.Am J Surg. 1982; 144: 115-123
- Femoropopliteal graft failures: clinical consequences and success of secondary reconstructions.Arch Surg. 1983; 118: 1043-1047
- The geriatric amputee.Ann Surg. 1972; 176: 305-314
- Major amputations after femoropopliteal bypass procedures.Am J Surg. 1975; 129: 495-499
- Improved results with femoropopliteal vein grafts for limb salvage.Arch Surg. 1977; 112: 567-570
- Results of 100 consecutive femoropopliteal vein grafts for limb salvage.Ann Surg. 1978; 188: 162-166
- Femoropopliteal bypass for limb salvage.Surgery. 1977; 81: 452-458
- Influence of failed vascular bypass procedures on conversion of below-knee to above-knee amputation levels.Surgery. 1982; 91: 64-69
- Noninvasive hemodynamic evaluation in selection of amputation level.Surg Gynecol Obstet. 1979; 149: 241-244
- Use of doppler pressure measurements in predicting success in amputation of the leg.Am J Surg. 1980; 139: 303-306
- Distal blood pressure as a guidance in choice of amputation level.Scand J Clin Lab Invest. 1973; 128 ([Suppl]): 245-249
2Presented at the 18th Annual Meeting of the Society for Clinical Vascular Surgery, Palm Desert, California, March 7–11, 1990.
© 1990 Reed Publishing USA. Published by Elsevier Inc.