Amputation may not be best option for severe circulation problems
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.