Az alsó végtag akut veroér-elzáródásának sebészi kezelésével 20 ev során szerzett tapasztalataink.

Translated title of the contribution: Experiences in surgical management of acute arterial occlusions of the lower limb in the course of 20 years

Péter Kaliszky, Gyula Jámbor, András Papp, B. Molnár

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: In Hungary surgeons perform every year more then 2000 operations for treatment of acute arterial occlusion. Because of the advanced age and poor general condition of these patients, the postoperative mortality and complication rate is considerable. AIM: Authors analyzed changes in the etiology and therapy of acute arterial occlusions of lower limb in the last 20 years in a retrospective study. PATIENTS AND METHODS: 563 patients were operated on with acute arterial occlusion of lower extremities from 1983 to 2002 by the authors. Patients with vascular surgery in their history were excluded from this study. Student's two-samples "t"-test, chi2- and Fisher's exact test were used in Statistica 6.0 for statistics. RESULTS: Period of 1983-1992 compared to period of 1993-2002 they found increased rate of occlusions caused by thrombosis (35 vs. 46%, p <0.01) and increased number of acute vascular reconstructions performed with indication of acute thrombosis (17.6 vs. 47.0%, p <0.001). Mortality was higher in patients operated with embolism than in patients with thrombosis (17.7 vs. 11.6%, p <0.01), but the ratio of postoperative amputation following embolectomy was lower than following thrombectomy (5.0 vs. 16.0%, p <0.01). Thrombectomy itself could solve the occlusion caused by thrombosis only in 50% of cases. Results of reoperations following unsuccessful thrombectomies are very poor. Amputation was necessary in 6.8% (in 5 cases of 74 patients) after primary reconstructions, but in 28.6% (in 14 cases of 49 patients) after reoperations. There was no significant difference in postoperative mortality among primary reconstructed, reoperated and conservatively treated groups. CONCLUSIONS: By author's experience, in cases of acute occlusion caused by thrombosis as a complication of chronic obliterative arterial disease, basic cause of occlusion should be searched for and--if conditions are suitable--procedure should be extend to vascular reconstruction.

Original languageHungarian
Pages (from-to)1835-1840
Number of pages6
JournalOrvosi Hetilap
Volume145
Issue number36
Publication statusPublished - Sep 5 2004

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Lower Extremity
Thrombosis
Thrombectomy
Blood Vessels
Reoperation
Amputation
Mortality
Embolectomy
Hungary
Embolism
Retrospective Studies
History
Students
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

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Az alsó végtag akut veroér-elzáródásának sebészi kezelésével 20 ev során szerzett tapasztalataink. / Kaliszky, Péter; Jámbor, Gyula; Papp, András; Molnár, B.

In: Orvosi Hetilap, Vol. 145, No. 36, 05.09.2004, p. 1835-1840.

Research output: Contribution to journalArticle

Kaliszky, Péter ; Jámbor, Gyula ; Papp, András ; Molnár, B. / Az alsó végtag akut veroér-elzáródásának sebészi kezelésével 20 ev során szerzett tapasztalataink. In: Orvosi Hetilap. 2004 ; Vol. 145, No. 36. pp. 1835-1840.
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abstract = "INTRODUCTION: In Hungary surgeons perform every year more then 2000 operations for treatment of acute arterial occlusion. Because of the advanced age and poor general condition of these patients, the postoperative mortality and complication rate is considerable. AIM: Authors analyzed changes in the etiology and therapy of acute arterial occlusions of lower limb in the last 20 years in a retrospective study. PATIENTS AND METHODS: 563 patients were operated on with acute arterial occlusion of lower extremities from 1983 to 2002 by the authors. Patients with vascular surgery in their history were excluded from this study. Student's two-samples {"}t{"}-test, chi2- and Fisher's exact test were used in Statistica 6.0 for statistics. RESULTS: Period of 1983-1992 compared to period of 1993-2002 they found increased rate of occlusions caused by thrombosis (35 vs. 46{\%}, p <0.01) and increased number of acute vascular reconstructions performed with indication of acute thrombosis (17.6 vs. 47.0{\%}, p <0.001). Mortality was higher in patients operated with embolism than in patients with thrombosis (17.7 vs. 11.6{\%}, p <0.01), but the ratio of postoperative amputation following embolectomy was lower than following thrombectomy (5.0 vs. 16.0{\%}, p <0.01). Thrombectomy itself could solve the occlusion caused by thrombosis only in 50{\%} of cases. Results of reoperations following unsuccessful thrombectomies are very poor. Amputation was necessary in 6.8{\%} (in 5 cases of 74 patients) after primary reconstructions, but in 28.6{\%} (in 14 cases of 49 patients) after reoperations. There was no significant difference in postoperative mortality among primary reconstructed, reoperated and conservatively treated groups. CONCLUSIONS: By author's experience, in cases of acute occlusion caused by thrombosis as a complication of chronic obliterative arterial disease, basic cause of occlusion should be searched for and--if conditions are suitable--procedure should be extend to vascular reconstruction.",
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AU - Molnár, B.

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