Vascular Surgery: Possible Adverse Effect on Extent of Subsequent Lower Limb Amputation

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Abstract
The influence of previous vascular surgery on the level of amputation was examined retrospectively in 345 amputations (66 bilateral) in 279 patients with peripheral vascular disease. Seventy-two patients (38% diabetic) had previous vascular surgery on 74 limbs and 207 (65% diabetic) had no history of vascular surgery on 271 limbs. In patients with previous vascular surgery, above-knee amputation was done on 55% of limbs versus 71% of limbs in patients with no previous vascular surgery (P < .05), despite a lower incidence of diabetes in the former group. We conclude that although reconstructive vascular surgery is an effective treatment for vascular insufficiency, occasionally it not only fails, but is associated with an increased incidence of above-knee amputation.

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