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Low Risk of Procedure Related Major Amputation Following Revascularisation for Intermittent Claudication : A Population Based Study

Djerf, Henrik ; Hellman, Jonas ; Baubeta Fridh, Erik LU orcid ; Andersson, Manne ; Nordanstig, Joakim and Falkenberg, Mårten (2020) In European journal of vascular and endovascular surgery 59(5). p.817-822
Abstract

Objective: To investigate the risk of procedure-related major amputation attributable to revascularization for intermittent claudication (IC) in a population-based observational cohort study. Methods: All patients who underwent open or endovascular lower limb revascularisation for IC in Sweden between 12 May 2008 and 31 December 2012 were identified from the Swedish National Quality Registry for Vascular Surgery (Swedvasc) and data on above ankle amputations were extracted from the National Patient Registry. Any uncertainty regarding amputation level and laterality was resolved by reviewing medical charts. For the final analysis, complete medical records of all patients with IC, having ipsilateral amputation after the revascularisation... (More)

Objective: To investigate the risk of procedure-related major amputation attributable to revascularization for intermittent claudication (IC) in a population-based observational cohort study. Methods: All patients who underwent open or endovascular lower limb revascularisation for IC in Sweden between 12 May 2008 and 31 December 2012 were identified from the Swedish National Quality Registry for Vascular Surgery (Swedvasc) and data on above ankle amputations were extracted from the National Patient Registry. Any uncertainty regarding amputation level and laterality was resolved by reviewing medical charts. For the final analysis, complete medical records of all patients with IC, having ipsilateral amputation after the revascularisation procedure, were reviewed. Patients wrongly classified as having IC were excluded. Ipsilateral amputations within one year of the revascularisation were defined as procedure related. Results: Altogether, 5 860 patients revascularised for IC were identified of whom 109 were registered to have undergone a post-operative ipsilateral lower limb amputation during a median follow up of 3.9 years (standard deviation 1.5 y). Seventeen were duplicate registrations and 51 were patients with chronic limb threatening ischaemia, misclassified as IC in the registry. One patient had not undergone any revascularisation, one was revascularised for a popliteal artery aneurysm, one was revascularised for acute limb ischaemia, one had a minor amputation only, and one patient was not amputated at all. Twenty-seven were amputated more than one year after the procedure. Thus, the major amputation rate within one year of revascularisation for IC was 0.2% (n = 9/5 860). Conclusion: Revascularisation for IC in a contemporary setting confers a low but existing risk of procedure related major amputation within the first post-procedural year.

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author
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publishing date
type
Contribution to journal
publication status
published
keywords
Amputation, Intermittent claudication, Peripheral arterial disease, Surgery
in
European journal of vascular and endovascular surgery
volume
59
issue
5
pages
817 - 822
publisher
Elsevier
external identifiers
  • pmid:31866238
  • scopus:85076852145
ISSN
1078-5884
DOI
10.1016/j.ejvs.2019.11.023
language
English
LU publication?
no
additional info
Funding Information: This study was supported by the Swedish Research Council and by grants from the Swedish state under the agreement between the Swedish government and the county councils (the ALF agreement [ALFGBG-785741 and ALFGBG-822921]). We acknowledge the steering committee of the Swedvasc registry: L. Blomgren; M. Jonsson; J. Starck; K. Bj?rses; K. Djavani Gidlund; A. Daryapeyma; K. Mani; and H. Lindgren. We also would like to thank the participating centres: Kalmar County Hospital; S?dra ?lvsborg Hospital; Sk?ne University Hospital; NU Hospital Group; Falun Hospital; Hudiksvall Hospital; S?dersjukhuset; Karlstad Hospital; ?rebro University Hospital; Sunderbyn Hospital; Ryhov Hospital; Hallands Hospital Halmstad; Sundsvall Hospital; University Hospital of Ume?; University Hospital of Link?ping; Eksj? Hospital; M?larssjukhuset; Skaraborg Hospital; Uppsala University Hospital; ?stersund Hospital; G?vle Hospital; and V?ster?s Hospital. Funding Information: This study was supported by the Swedish Research Council and by grants from the Swedish state under the agreement between the Swedish government and the county councils (the ALF agreement [ ALFGBG-785741 and ALFGBG-822921 ]). We acknowledge the steering committee of the Swedvasc registry: L. Blomgren; M. Jonsson; J. Starck; K. Björses; K. Djavani Gidlund; A. Daryapeyma; K. Mani; and H. Lindgren. We also would like to thank the participating centres: Kalmar County Hospital; Södra Älvsborg Hospital; Skåne University Hospital; NU Hospital Group; Falun Hospital; Hudiksvall Hospital; Södersjukhuset; Karlstad Hospital; Örebro University Hospital; Sunderbyn Hospital; Ryhov Hospital; Hallands Hospital Halmstad; Sundsvall Hospital; University Hospital of Umeå; University Hospital of Linköping; Eksjö Hospital; Mälarssjukhuset; Skaraborg Hospital; Uppsala University Hospital; Östersund Hospital; Gävle Hospital; and Västerås Hospital. Publisher Copyright: © 2019 European Society for Vascular Surgery
id
7866f456-cad1-4d55-963d-fac9195bf11e
date added to LUP
2022-04-04 10:55:37
date last changed
2024-05-05 10:16:02
@article{7866f456-cad1-4d55-963d-fac9195bf11e,
  abstract     = {{<p>Objective: To investigate the risk of procedure-related major amputation attributable to revascularization for intermittent claudication (IC) in a population-based observational cohort study. Methods: All patients who underwent open or endovascular lower limb revascularisation for IC in Sweden between 12 May 2008 and 31 December 2012 were identified from the Swedish National Quality Registry for Vascular Surgery (Swedvasc) and data on above ankle amputations were extracted from the National Patient Registry. Any uncertainty regarding amputation level and laterality was resolved by reviewing medical charts. For the final analysis, complete medical records of all patients with IC, having ipsilateral amputation after the revascularisation procedure, were reviewed. Patients wrongly classified as having IC were excluded. Ipsilateral amputations within one year of the revascularisation were defined as procedure related. Results: Altogether, 5 860 patients revascularised for IC were identified of whom 109 were registered to have undergone a post-operative ipsilateral lower limb amputation during a median follow up of 3.9 years (standard deviation 1.5 y). Seventeen were duplicate registrations and 51 were patients with chronic limb threatening ischaemia, misclassified as IC in the registry. One patient had not undergone any revascularisation, one was revascularised for a popliteal artery aneurysm, one was revascularised for acute limb ischaemia, one had a minor amputation only, and one patient was not amputated at all. Twenty-seven were amputated more than one year after the procedure. Thus, the major amputation rate within one year of revascularisation for IC was 0.2% (n = 9/5 860). Conclusion: Revascularisation for IC in a contemporary setting confers a low but existing risk of procedure related major amputation within the first post-procedural year.</p>}},
  author       = {{Djerf, Henrik and Hellman, Jonas and Baubeta Fridh, Erik and Andersson, Manne and Nordanstig, Joakim and Falkenberg, Mårten}},
  issn         = {{1078-5884}},
  keywords     = {{Amputation; Intermittent claudication; Peripheral arterial disease; Surgery}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{817--822}},
  publisher    = {{Elsevier}},
  series       = {{European journal of vascular and endovascular surgery}},
  title        = {{Low Risk of Procedure Related Major Amputation Following Revascularisation for Intermittent Claudication : A Population Based Study}},
  url          = {{http://dx.doi.org/10.1016/j.ejvs.2019.11.023}},
  doi          = {{10.1016/j.ejvs.2019.11.023}},
  volume       = {{59}},
  year         = {{2020}},
}