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Acute ischemia and bypass occlusion: current options

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Acute ischemia and bypass occlusion: current options. / Larena-Avellaneda, A; Debus, E S; Kölbel, T; Wipper, S; Diener, H.

In: J CARDIOVASC SURG, Vol. 55, No. 2 Suppl 1, 04.2014, p. 187-194.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Larena-Avellaneda, A, Debus, ES, Kölbel, T, Wipper, S & Diener, H 2014, 'Acute ischemia and bypass occlusion: current options', J CARDIOVASC SURG, vol. 55, no. 2 Suppl 1, pp. 187-194.

APA

Larena-Avellaneda, A., Debus, E. S., Kölbel, T., Wipper, S., & Diener, H. (2014). Acute ischemia and bypass occlusion: current options. J CARDIOVASC SURG, 55(2 Suppl 1), 187-194.

Vancouver

Larena-Avellaneda A, Debus ES, Kölbel T, Wipper S, Diener H. Acute ischemia and bypass occlusion: current options. J CARDIOVASC SURG. 2014 Apr;55(2 Suppl 1):187-194.

Bibtex

@article{cbde1575154d4c508cd83662feec3f7f,
title = "Acute ischemia and bypass occlusion: current options",
abstract = "AIM: Acute limb ischemia (ALI) and bypass occlusion are vascular emergencies and require immediate decisions and therapy. There are a lot of options, and the vascular therapist should be able to provide multiple alternatives. In this article we give on overview over the actual therapeutic options and present the data of a retrospective analysis of bypass occlusions.METHODS: Therapeutic options of ALI are discussed according to the current literature. For the retrospective study, patients with acute or subacute occlusion of below knee alloplastic bypass were included. Endpoints of the study were secondary patency and limb salvage rate. A prognostic index was calculated to estimate the specific risk.RESULTS: We analyzed 262 bypass occlusions; 161 patients were male. The majority of patients (N.=249) presented with threatened limb at readmission. After one year, 2/3 of the bypasses showed a reocclusion. Introducing the therapy with bypass thrombolysis enhanced the prognosis significantly. Of the factors examined, cardiac and renal insufficiency had a significant poor influence, whereas therapy with Coumadin enhanced the prognosis in terms of patency. The prognostic index was calculated using the factors identified as relevant in the multivariate analysis.DISCUSSION: Despite all new technical tools, ALI and bypass occlusion is still associated with a significant risk for limb loss and mortality. Endovascular procedures are excellent options. The prognostic index may be a helpful tool in estimating the patency or risk of limb loss.",
keywords = "Acute Disease, Aged, Aged, 80 and over, Amputation, Blood Vessel Prosthesis Implantation/adverse effects, Chi-Square Distribution, Female, Graft Occlusion, Vascular/diagnosis, Humans, Ischemia/diagnosis, Kaplan-Meier Estimate, Limb Salvage, Lower Extremity/blood supply, Male, Middle Aged, Multivariate Analysis, Patient Readmission, Proportional Hazards Models, Regional Blood Flow, Reoperation, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Vascular Patency",
author = "A Larena-Avellaneda and Debus, {E S} and T K{\"o}lbel and S Wipper and H Diener",
year = "2014",
month = apr,
language = "English",
volume = "55",
pages = "187--194",
journal = "J CARDIOVASC SURG",
issn = "0021-9509",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "2 Suppl 1",

}

RIS

TY - JOUR

T1 - Acute ischemia and bypass occlusion: current options

AU - Larena-Avellaneda, A

AU - Debus, E S

AU - Kölbel, T

AU - Wipper, S

AU - Diener, H

PY - 2014/4

Y1 - 2014/4

N2 - AIM: Acute limb ischemia (ALI) and bypass occlusion are vascular emergencies and require immediate decisions and therapy. There are a lot of options, and the vascular therapist should be able to provide multiple alternatives. In this article we give on overview over the actual therapeutic options and present the data of a retrospective analysis of bypass occlusions.METHODS: Therapeutic options of ALI are discussed according to the current literature. For the retrospective study, patients with acute or subacute occlusion of below knee alloplastic bypass were included. Endpoints of the study were secondary patency and limb salvage rate. A prognostic index was calculated to estimate the specific risk.RESULTS: We analyzed 262 bypass occlusions; 161 patients were male. The majority of patients (N.=249) presented with threatened limb at readmission. After one year, 2/3 of the bypasses showed a reocclusion. Introducing the therapy with bypass thrombolysis enhanced the prognosis significantly. Of the factors examined, cardiac and renal insufficiency had a significant poor influence, whereas therapy with Coumadin enhanced the prognosis in terms of patency. The prognostic index was calculated using the factors identified as relevant in the multivariate analysis.DISCUSSION: Despite all new technical tools, ALI and bypass occlusion is still associated with a significant risk for limb loss and mortality. Endovascular procedures are excellent options. The prognostic index may be a helpful tool in estimating the patency or risk of limb loss.

AB - AIM: Acute limb ischemia (ALI) and bypass occlusion are vascular emergencies and require immediate decisions and therapy. There are a lot of options, and the vascular therapist should be able to provide multiple alternatives. In this article we give on overview over the actual therapeutic options and present the data of a retrospective analysis of bypass occlusions.METHODS: Therapeutic options of ALI are discussed according to the current literature. For the retrospective study, patients with acute or subacute occlusion of below knee alloplastic bypass were included. Endpoints of the study were secondary patency and limb salvage rate. A prognostic index was calculated to estimate the specific risk.RESULTS: We analyzed 262 bypass occlusions; 161 patients were male. The majority of patients (N.=249) presented with threatened limb at readmission. After one year, 2/3 of the bypasses showed a reocclusion. Introducing the therapy with bypass thrombolysis enhanced the prognosis significantly. Of the factors examined, cardiac and renal insufficiency had a significant poor influence, whereas therapy with Coumadin enhanced the prognosis in terms of patency. The prognostic index was calculated using the factors identified as relevant in the multivariate analysis.DISCUSSION: Despite all new technical tools, ALI and bypass occlusion is still associated with a significant risk for limb loss and mortality. Endovascular procedures are excellent options. The prognostic index may be a helpful tool in estimating the patency or risk of limb loss.

KW - Acute Disease

KW - Aged

KW - Aged, 80 and over

KW - Amputation

KW - Blood Vessel Prosthesis Implantation/adverse effects

KW - Chi-Square Distribution

KW - Female

KW - Graft Occlusion, Vascular/diagnosis

KW - Humans

KW - Ischemia/diagnosis

KW - Kaplan-Meier Estimate

KW - Limb Salvage

KW - Lower Extremity/blood supply

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Patient Readmission

KW - Proportional Hazards Models

KW - Regional Blood Flow

KW - Reoperation

KW - Retrospective Studies

KW - Risk Factors

KW - Time Factors

KW - Treatment Outcome

KW - Vascular Patency

M3 - SCORING: Review article

C2 - 24796913

VL - 55

SP - 187

EP - 194

JO - J CARDIOVASC SURG

JF - J CARDIOVASC SURG

SN - 0021-9509

IS - 2 Suppl 1

ER -