Determinants of amputation and mortality following thromboembolectomy in native acute lower limb arterial occlusions, the influence of early intervention: A retrospective cohort study

Abstract

Aim: In acute arterial occlusion, there is a sudden blockage of blood flow to the extremity, threatening its viability. Early/emergency intervention is required to eliminate the risk of amputation, but some of these cases receive a delayed diagnosis. The aim of this study is to evaluate the influence of surgical timing on the incidence of amputation and other factors affecting the risk of extremity loss. Methods: A total of 154 patients who underwent thromboembolectomy were analyzed. The patients were categorized into three groups, as follows: Group 1 included patients with symptoms present for less than 12 hours, Group 2 comprised those with symptoms present for more than 12 hours but less than one week, and Group 3 included patients with symptoms present for more than one week. The groups were evaluated in terms of amputation and mortality. Results: The incidence of amputation was significantly lower in Group 1 compared to the other two groups (P<0.05), and similar between Groups 2 and 3. In-hospital mortality did not significantly differ between the groups. When categorical and continuous variables were evaluated, a significant relationship was found between the risk of amputation and increasing age, female gender, diabetes, and iliac occlusion (P<0.05). The risk of in-hospital mortality was higher in females and in cases with cardiac arrhythmia (P<0.05). Conclusion: Early surgical embolectomy is more successful in limb salvage. The risk of amputation is increased in diabetics, females, the elderly, and in proximal arterial occlusion.