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ARTERIAL LESIONS IN SEVERE LOWER LIMB ISCHAEMIA: A PROSPECTIVE STUDY OF 100 CONSECUTIVE ISCHAEMIC LIMBS IN A HONG KONG CHINESE POPULATION
Author(s) -
Ahchong Kian,
Chiu Kai Ming,
Lo Siu Fai,
Iu Po Ping,
Yip Andrew Wai Chun
Publication year - 1999
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1046/j.1440-1622.1999.01504.x
Subject(s) - medicine , prospective cohort study , chinese population , lower limb , population , ischemia , physical therapy , surgery , environmental health , biochemistry , chemistry , genotype , gene
Background : The pattern and distribution of arterial lesions in a local Chinese population were studied to assess the feasibility of reconstruction and the possibility of avoiding major amputation of ischaemic limbs. Method : Between March 1995 and August 1997, 90 consecutive patients with 100 severely ischaemic lower limbs and their arteriograms were analysed. There were 48 female and 42 male patients with a mean age of 72 years. All the patients were in fair general health, did not have foot pulses and were willing to undergo major arterial reconstruction. Ten patients had bilateral limb ischaemia and 94 of the ischaemic limbs were affected by rest pain with or without ulcer and/or gangrene. The remaining six patients had debilitating claudication. These lesions were classified into low‐grade (less than 50% stenosis), high‐grade (50–90% stenosis) and critical (> 90% stenosis to occlusion). Results : Critically stenotic or occlusive lesions were present in 16% of aorto‐iliac segments; 76% of femoropopliteal arteries; and 82% of trifurcation and infrapopliteal segments. In at least 27 patients one of the two main foot arteries was also severely diseased. The present analysis suggested that 79 of these ischaemic limbs had reconstructable lesions. Sixteen were not suitable for intervention and in five patients the reconstructability was uncertain radiologically. Conclusion : Contrary to local belief, the majority of patients in the Chinese community with severe lower limb ischaemia without foot pulses would have technically reconstructable arterial lesions and could benefit from a revascularization procedure.