European Journal of Vascular & Endovascular Surgery
Volume 17, Issue 1 , Pages 35-40, January 1999

Level of Amputation Following Failed Arterial Reconstruction Compared to Primary Amputation – a Meta-analysis

Danish Amputation Register in Department of Orthopedic Surgery, County Hospital Herlev, Department of Orthopedic Surgery, Hvidovre Hospital, Copenhagen Woundhealing Center, Bispebjerg Hospital, Denmark

Accepted 10 June 1998.

Article Outline

Abstract 

Objectives:to determine if the level of amputation after failed vascular reconstruction was comparable to the level of amputation after primary amputation.Design and methods:medline literature search (1975–1996), meta-analysis.Results:the odds ratio of transtibial to transfemoral (TT/TF) amputations was 927/657=1.41 (95% confidence limits: 1.278–1.561) in postrevascularisation amputation (PRVA) and 1590/1162=1.37 (95% confidence limits: 1.269–1.477) in primary amputation (PA) (p=0.65). The pooled data show that the number of conversions from transtibial (TT) to transfemoral (TF) amputations due to amputation stump complications were 85/369 (23%) in PRVA against 93/752 (12.4%) in PA (p<0.01).Conclusions:we could not detect any difference in TT/TF ratio between PRVA and PA. However, the risk of conversion i.e. reamputation to a higher level is higher after PRVA compared to PA. The chance of having a successful transtibial amputation is approximately 58% for postrevacularisation amputation as well as for primary amputations. An aggressive approach towards vascular reconstruction seems justified.

Keywords: Failed arterial reconstruction, Amputation, Level of amputation.

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  • f1 Please address all correspondence to: L. Bo Ebskov, Anyvej 10, 3500 Værløse, Denmark.

PII: S1078-5884(98)90689-X

doi:10.1053/ejvs.1998.0689

European Journal of Vascular & Endovascular Surgery
Volume 17, Issue 1 , Pages 35-40, January 1999

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