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World Journal of Surgery

, Volume 39, Issue 8, pp 2090–2095 | Cite as

Conservative Treatment in Selected Patients with Severe Critical Limb Ischemia

  • Adriaan R. ThomasEmail author
  • Jelle W. Raats
  • Mare M. A. Lensvelt
  • Hans G. W. de Groot
  • Eelco J. Veen
  • Lijckle van der Laan
Original Scientific Report

Abstract

Objective

To assess the outcome of conservative treatment of severe critical limb ischemia (CLI) classified as Rutherford 5/6.

Background

The preferred therapy for CLI is either endovascular revascularization or bypass surgery. With a growing aged population with more serious comorbidities, these therapies are not always a viable option. Primary amputation leads to decreased mobility and a reduced quality of life. There is a lack of literature regarding the outcome of conservative therapy.

Methods

Hospital charts were reviewed of all patients who were diagnosed with Rutherford classification 5–6 and received conservative treatment and lacked interventional options. Outcome measures were mortality, complete wound closure, and limb salvage rate.

Results

38 patients were included with a median age of 80 years (range 57–97). The amputation rate during follow-up was 16 %. In 58 % of patients, complete wound closure was achieved. All-cause mortality was 58 % with a 2-year survivability rate of 55 %.

Conclusions

Conservative management in our selected patients with CLI results in a moderate rate of wound closure and acceptable amputation rates albeit with a high mortality rate. For patients not eligible for endovascular revascularization or bypass surgery, conservative treatment could be a viable option besides primary limb amputation.

Keywords

Magnetic Resonance Angiography Peripheral Arterial Disease Ankle Brachial Index Critical Limb Ischemia Major Amputation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We would like to thank our specialized wound care practitioners for their help with delivering the necessary data.

Disclosure

None.

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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Adriaan R. Thomas
    • 1
    Email author
  • Jelle W. Raats
    • 1
  • Mare M. A. Lensvelt
    • 1
  • Hans G. W. de Groot
    • 1
  • Eelco J. Veen
    • 1
  • Lijckle van der Laan
    • 1
  1. 1.Department of SurgeryAmphia HospitalBredaThe Netherlands

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