Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years

Akyol, Furkan Burak; Doganci, Suat; Bolcal, Cengiz; Karabacak, Kubilay; kubat, emre; Erol, Gokhan; KADAN, MURAT

doi:10.9739/tjvs.2020.648

Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years

Emre KUBAT, (Girilmemişş)

Gökhan EROL, (Girilmemişş)

Furkan Burak AKYOL, (Girilmemişş)

Kubilay KARABACAK, (Girilmemişş)

Murat KADAN, (Girilmemişş)

Suat DOĞANCI, (Girilmemişş)

Cengiz BOLCAL (Girilmemişş)

Turkish journal of vascular surgery

6 1

Yıl: 2020 Cilt: 29 Sayı: 2 Sayfa Aralığı: 84 - 89 Metin Dili: İngilizce DOI: 10.9739/tjvs.2020.648 İndeks Tarihi: 18-11-2020

Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years

Öz:

Objectives: This study aims to compare embolectomy results for acute lower limb ischemia (ALLI) between patients aged ≥80 years and<80 years.Patients and methods: A total of 65 patients (39 males, 26 females; mean age, 70.2±17.9 years; range, 20 to 94 years) who were diagnosedwith ALLI and underwent urgent thromboembolectomy in our hospital between December 2016 and August 2018 were retrospectivelyanalyzed. The patients were divided into two groups according to their age as ≥80 years (Group 1) and <80 years (Group 2). Data includingbaseline demographic and clinical characteristics and postoperative data were recorded.Results: There was a male predominance in Group 2, while the majority of patients were females in Group 1. Of the patients, 29 (44.6%)were operated from the right lower limb, 32 (49.2%) from the left lower limb, and four (6.2%) bilaterally. There was no significant differencein the rate of postoperative hematoma, wound infection, compartment syndrome, acute renal insufficiency, amputation, and early mortalitybetween the groups. However, the rate of amputation was statistically significantly higher in Group 2 with late presentation, than Group 1.Conclusion: Our study results show similar results of urgent surgical thromboembolectomy between over and under 80-year-old patientswith ALLI. We believe that the age of the patient should not be an exclusion criterion for embolectomy due to ALLI.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Bozkurt AK. Akut bacak iskemisi. In: Bozkurt AK, editör. Periferik Arter ve Ven Hastalıkları. Ulusal Tedavi Kılavuzu 2016. İstanbul: Bayçınar Tıbbi Yayıncılık; 2016. s. 44-61
2. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 2007;45:S5-67.
3. Earnshaw JJ. Acute ischemia: Evaluation and decision making. In: Sidawy AN, Perler BA, editors. Rutherford’s Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia: Elsevier; 2017. p. 4372-4404.
4. Zaraca F, Ponzoni A, Sbraga P, Ebner JA, Giovannetti R, Ebner H. Factors affecting long-term outcomes after thromboembolectomy for acute lower limb ischemia. Minerva Chir 2012;67:49-57.
5. Piffaretti G, Angrisano A, Franchin M, Ferrario M, Rivolta N, Bacuzzi A, et al. Risk factors analysis of thromboembolectomy for acute thromboembolic lower extremity ischemia in native arteries. J Cardiovasc Surg 2018;59:810-6.6. Ouriel K. Acute Arterial Occlusion of the Lower Extremities. In: Ascer E, Veith FJ, Gloviczki P, editors. Haimovici’s Vascular Surgery. 6th ed. Chichester: WileyBlackwell; 2012; 703-710.
7. Aldağ M, Öztekin A, Bademci MŞ, Kocaaslan C, Denli Yalvaç EŞ, Aydın E. Surgical results of acute thromboembolic limb ischemia in octogenarians. Damar Cer Derg 2018;27:111-6.
8. Galzerano G, de Donato G, Setacci F, Sirignano P, Sauro L, Cappelli A, et al. Acute limb ischemia in nonagenarians. J Cardiovasc Surg 2013;54:625-31.
9. Campbell WB, Ridler BM, Szymanska TH. Two-year follow-up after acute thromboembolic limb ischaemia: the importance of anticoagulation. Eur J Vasc Endovasc Surg 2000;19:169-73.
10. Earnshaw JJ1, Whitman B, Foy C. National Audit of Thrombolysis for Acute Leg Ischemia (NATALI): clinical factors associated with early outcome. J Vasc Surg 2004;39:1018-25.
11. Amendt K, Schömig A, Wilhelm C, Hsu E, Weiss T, Diehm C, et al. Intravascular ultrasound (IVUS) in patients with peripheral arterial occlusive disease (PAOD). Vasa 1992;21:27-38.
12. Kempe K, Starr B, Stafford JM, Islam A, Mooney A, Lagergren E, et al. Results of surgical management of acute thromboembolic lower extremity ischemia. J Vasc Surg 2014;60:702-7.
13. Iyem H, Eren MN. Should embolectomy be performed in late acute lower extremity arterial occlusions? Vasc Health Risk Manag 2009;5:621-6.
14. Fogarty TJ, Cranley JJ. Catheter technic for arterial embolectomy. Ann Surg 1965;161:325-30.
15. Baril DT, Patel VI, Judelson DR, Goodney PP, McPhee JT, Hevelone ND, et al. Outcomes of lower extremity bypass performed for acute limb ischemia. J Vasc Surg 2013;58:949- 56.
16. Lurie F, Vaidya V, Comerota AJ. Clinical outcomes and costeffectiveness of initial treatment strategies for nonembolic acute limb ischemia in real-life clinical settings. J Vasc Surg 2015;61:138-46.
17. Enezate TH, Omran J, Mahmud E, Patel M, AbuFadel MS, White CJ, et al. Endovascular versus surgical treatment for acute limb ischemia: a systematic review and meta-analysis of clinical trials. Cardiovasc Diagn Ther 2017;7:264-71.
18. Plate G, Oredsson S, Lanke J. When is thrombolysis for acute lower limb ischemia worthwhile? Eur J Vasc Endovasc Surg 2009;37:206-12.
19. Olinic DM, Stanek A, Tătaru DA, Homorodean C, Olinic M. Acute Limb Ischemia: An Update on Diagnosis and Management. J Clin Med 2019;8. pii: E1215.
20. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59:255-63.
21. Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med 2011;27:1-15.
22. Klaphake S, de Leur K, Mulder PGH, Ho GH, de Groot HGW, Veen EJ, et al. Life Expectancy and Outcome of Different Treatment Strategies for Critical Limb Ischemia in the Elderly Patients. Ann Vasc Surg 2018;46:241-8.
23. Ouriel K, Veith FJ. Acute lower limb ischemia: determinants of outcome. Surgery 1998;124:336-41.
24. Conte MS. Critical appraisal of surgical revascularization for critical limb ischemia. J Vasc Surg 2013;57:8S-13S.

APA	kubat e, Erol G, Akyol F, Karabacak K, KADAN M, Doganci S, Bolcal C (2020). Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. , 84 - 89. 10.9739/tjvs.2020.648
Chicago	kubat emre,Erol Gokhan,Akyol Furkan Burak,Karabacak Kubilay,KADAN MURAT,Doganci Suat,Bolcal Cengiz Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. (2020): 84 - 89. 10.9739/tjvs.2020.648
MLA	kubat emre,Erol Gokhan,Akyol Furkan Burak,Karabacak Kubilay,KADAN MURAT,Doganci Suat,Bolcal Cengiz Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. , 2020, ss.84 - 89. 10.9739/tjvs.2020.648
AMA	kubat e,Erol G,Akyol F,Karabacak K,KADAN M,Doganci S,Bolcal C Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. . 2020; 84 - 89. 10.9739/tjvs.2020.648
Vancouver	kubat e,Erol G,Akyol F,Karabacak K,KADAN M,Doganci S,Bolcal C Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. . 2020; 84 - 89. 10.9739/tjvs.2020.648
IEEE	kubat e,Erol G,Akyol F,Karabacak K,KADAN M,Doganci S,Bolcal C "Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years." , ss.84 - 89, 2020. 10.9739/tjvs.2020.648
ISNAD	kubat, emre vd. "Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years". (2020), 84-89. https://doi.org/10.9739/tjvs.2020.648

APA	kubat e, Erol G, Akyol F, Karabacak K, KADAN M, Doganci S, Bolcal C (2020). Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. Turkish journal of vascular surgery, 29(2), 84 - 89. 10.9739/tjvs.2020.648
Chicago	kubat emre,Erol Gokhan,Akyol Furkan Burak,Karabacak Kubilay,KADAN MURAT,Doganci Suat,Bolcal Cengiz Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. Turkish journal of vascular surgery 29, no.2 (2020): 84 - 89. 10.9739/tjvs.2020.648
MLA	kubat emre,Erol Gokhan,Akyol Furkan Burak,Karabacak Kubilay,KADAN MURAT,Doganci Suat,Bolcal Cengiz Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. Turkish journal of vascular surgery, vol.29, no.2, 2020, ss.84 - 89. 10.9739/tjvs.2020.648
AMA	kubat e,Erol G,Akyol F,Karabacak K,KADAN M,Doganci S,Bolcal C Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. Turkish journal of vascular surgery. 2020; 29(2): 84 - 89. 10.9739/tjvs.2020.648
Vancouver	kubat e,Erol G,Akyol F,Karabacak K,KADAN M,Doganci S,Bolcal C Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years. Turkish journal of vascular surgery. 2020; 29(2): 84 - 89. 10.9739/tjvs.2020.648
IEEE	kubat e,Erol G,Akyol F,Karabacak K,KADAN M,Doganci S,Bolcal C "Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years." Turkish journal of vascular surgery, 29, ss.84 - 89, 2020. 10.9739/tjvs.2020.648
ISNAD	kubat, emre vd. "Comparison of embolectomy outcomes for acute lower limb ischemia between patients aged ≥80 years and <80 years". Turkish journal of vascular surgery 29/2 (2020), 84-89. https://doi.org/10.9739/tjvs.2020.648