Level of amputation following failed arterial reconstruction compared to primary amputation--a meta-analysis.
نویسندگان
چکیده
OBJECTIVES To determine if the level of amputation after failed vascular reconstruction was comparable to the level of amputation after primary amputation. 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 postrevascularisation 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 conversions from transtibial (TT) to transfemoral (TF) amputations due to amputation stump complications were 85/369 (23%) in PRVA against 93/752 (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 level is higher after PRVA compared to PA. The chance of having a successful transtibial amputation is approximately 58% for postrevascularisation amputation as well as for primary amputations. An aggressive approach towards vascular reconstruction seems justified.
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ورودعنوان ژورنال:
- European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
دوره 17 1 شماره
صفحات -
تاریخ انتشار 1999