Am­pu­ta­tion may not be best op­tion for se­vere cir­cu­la­tion prob­lems

The Borneo Post - Nature and health - - Alert -

TRY­ING to re­store blood flow may be bet­ter than am­pu­ta­tion for pa­tients with a se­ri­ous leg cir­cu­la­tion prob­lem called crit­i­cal limb is­chaemia, a new study con­tends. Crit­i­cal limb is­chaemia is the most se­vere form of pe­riph­eral artery dis­ease (PAD) and can lead to ul­cers, gan­grene and am­pu­ta­tion, the re­searchers said.

“Many pa­tients who are di­ag­nosed with crit­i­cal limb is­chaemia are told am­pu­ta­tion is their only op­tion,” ex­plained study author Dr Ji­had Mustapha. “But am­pu­ta­tion is as­so­ci­ated with many poor out­comes, in­clud­ing shorter sur­vival, de­pres­sion and loss of inde- pen­dence,” he added.

Mustapha is a car­di­ol­o­gist who spe­cialises in crit­i­cal limb is­chaemia at the Ad­vanced Car­diac & Vas­cu­lar Am­pu­ta­tion Preven­tion Cen­tres in Grand Rapids, Michi­gan. His team re­viewed the med­i­cal records of more than 72,000 Medi­care pa­tients di­ag­nosed with pri­mary crit­i­cal limb is­chaemia be­tween 2010 and 2015.

Over four years, sur­vival rates were 23 per cent among pa­tients who had am­pu­ta­tions; 38 per cent among those whose blood flow was re­stored by an­gio­plasty; and 40 per cent among those who had vein grafts to by­pass blocked blood ves­sels. “It’s im­por­tant that peo­ple know that am­pu­ta­tion is not the only solution, so al­ways get a sec­ond opin­ion,” Mustapha said in a jour­nal news re­lease. An­other vas­cu­lar ex­pert said the find­ings prove that am­pu­ta­tion isn’t the only al­ter­na­tive.

“The study suc­cess­fully points out that those ini­tially treated with mi­nor or major am­pu­ta­tion are in fact more likely to re­quire an­other major am­pu­ta­tion over the course of the next four years,” said Dr Maja Zaric, an in­ter­ven­tional car­di­ol­o­gist at Lenox Hill Hos­pi­tal in New York City.

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