Abstract
Delayed reperfusion of acute occlusive limb ischemia causes local and systemic serious consequences and is the main cause of morbidity and mortality in these patients. The aim of this study was to examine the outcome and risk factors of reperfusion injury in such cases. Patients and Methods: Retrospective review of all cases presented, to King Fahd Hospital of University, with acute occlusive limb ischemia more than 12 hours was performed between June 2004 and November 2012. Grades of ischemia, extremities, comorbidities, morbidities and mortality were recorded. Results: During the study period, 92 patients were included, 47 (51%) were embolic and the rest was thrombotic. On admission, 15 patients had grade III ischemia, 68 had grade IIb, 8 had grade IIa and 1 had grade I. Four patients died (4.3%) and 15 (16%) patients had amputation. The risk factors of amputation were age (p = 0.031), extremity (lower limb 21% vs. Upper limb 0%, p = 0.019), cause of ischemia (thrombotic 24% vs. embolic 8.5%, p = 0.049) and grade of ischemia (p = 0.001). Conclusion: Delayed reperfusion of acute occlusive ischemia carries acceptable morbidity and mortality and could be performed even in irreversible ischemia. The risk factors of amputation are age, lower limb ischemia, thrombosis and grade III ischemia.
Highlights
Acute limb ischemia (ALI) is sudden decrease in limb perfusion causing a potential threat to limb viability
All hospital records of acute limb ischemia treated between June 2004 and November 2012 were reviewed
The cause of ischemia was embolic in 47 patients (51%) and the rest was thrombotic
Summary
Acute limb ischemia (ALI) is sudden decrease in limb perfusion causing a potential threat to limb viability. It is usually due to acute occlusion of ar-. (2014) Reperfusion of Delayed Acute Occlusive Limb Ischemia: Is It Worthwhile? Reperfusion of a limb after prolonged ischemia causes cytokine liberation, leucocytes activation, increased expression of adhesion molecules, and activation of complement cascade and formation of toxic oxygen metabolites. Reactive oxygen intermediates may cause secondary cellular damage in the reperfused extremity and at remote organ sites [2]. Delayed revascularization causes liberation of ischemic metabolites, myoglobulinemia and myoglobunuria [3]. Such complications increase morbidity and mortality in these patients [2] [3]. The aim of this study was to examine the outcome and risk factors of reperfusion injury in such cases
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