Survival of Patients after Peripheral Bypass Surgery for Critical Limb Ischemia

Abstract

Objectives: To study the amputation-free survival, overall survival, and limb salvage rate in critical limb ischemia patients who underwent peripheral artery bypass surgery. Factors associated with survival were also evaluated.

Methods: From January 2006 to December 2008, all critical limb ischemia patients who underwent peripheral artery bypass surgery were recruited into retrospective study. All demographic data, associated or underlying diseases, clinical presentation, date of surgery, and date of last follow-up visit or death were obtained from electronic medical records of the patients.

Results: Seventy six patients who met inclusion criteria had average age of 60.5 ± 8.4 years. Most of them presented with tissue loss or gangrene (78.9%). There were 56.6% of male and 61.8% had underlying diabetes mellitus. The 1-year and 2-year amputation-free survival rates were 64.2% and 48.3% while the corresponding overall survival rates were 67.1% and 48.5% respectively. The 1-year and 2-year limb salvage rates were 84.2% and 77.6%. Among several factors of age, gender, smoking, clinical presentation, associated or underlying diseases including diabetes mellitus, hypertension, ischemic heart disease, hyperlipidemia, chronic renal failure, and cerebrovascular disease which were analyzed by multivariable analysis to find the association with survival, factors significantly associated with amputation-free survival were age > 60 years (hazard ration [HR], 2.2), ischemic heart disease (HR, 2.7) and chronic renal failure (HR, 2.6).

Conclusion: The 2-year amputation free survival and overall survival of critical limb ischemia patients who had peripheral bypass surgery were nearly 50%. Old age > 60 years and presence of ischemic heart disease or chronic renal failure were associated with worse outcome.