Major Lower Extremity Amputation
Archives of SurgeryPublished 1 April 2004
Bernadette Aulivola
Citations508
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TL;DR
Long-term survival is dismal for patients with DM and end-stage renal disease and those undergoing AKA, and Survivors with BKA require revision or conversion to AKA infrequently.
Abstract
Major amputation continues to result in significant morbidity and mortality. Survivors with BKA require revision or conversion to AKA infrequently. Long-term survival is dismal for patients with DM and end-stage renal disease and those undergoing AKA.
Keywords
Medicine
Journal of Vascular SurgeryFunctional outcome in a contemporary series of major lower extremity amputations
311 Citations2003Mark R. Nehler, Joseph Coll +10 more
It is found that vascular patients in a contemporary setting who require major lower extremity amputation and rehabilitation often remain independent despite infrequent prosthesis use and outdoor ambulation, and ability to predict ambulation after BKA in the vascular population is poor.
New England Journal of MedicineThe Use of Angioplasty, Bypass Surgery, and Amputation in the Management of Peripheral Vascular Disease
269 Citations1991Sean Tunis, Eric B Bass +1 more
In Maryland, the adoption of percutaneous transluminal angioplasty for peripheral vascular disease of the lower extremities has been associated with an increase in the use of peripheral bypass surgery and with no decline in lower-extremity amputations.
PubMedEnergy cost of ambulation in health and disability: a literature review.
248 Citations1978Fisher Sv, G Gullickson
The literature concerning ambulation of normal and disabled persons--amputees, hemiplegics, and paraplegics--is reviewed and the importance of a common terminology when measuring the energy cost of ambulation and the need to allow subjects to walk at their own most comfortable walking speed are stressed.
SurgeryPostoperative and late survival outcomes after major amputation: Findings from the Department of Veterans Affairs National Surgical Quality Improvement Program
168 Citations2001Joe Feinglass, William H. Pearce +7 more
A generic surgical risk model can be of use in stratifying prognosis after major amputation for older veterans who underwent above- or below-knee amputations in 119 Veterans Affairs (VA) hospitals from 1991 to 1995.
Journal of Vascular SurgeryResults of revascularization and amputation in severe lower extremity ischemia: A five-year clinical experience
167 Citations1985Robert W. Hobson, Thomas G. Lynch +5 more
FP and FT bypasses are preferred procedures if ASV is available, whereas use of PTFE should be limited to FP bypasses only, and BKA should be considered in cases of severe tibial disease only in the absence of a suitable ASV.
The American Journal of SurgeryNatural history of the leg amputee
113 Citations1977Nathan P. Couch, Jennifer K. David +2 more
Despite major impediments, satisfactory rehabilitation is accomplished frequently enough to justify optimism for a considerable number of geriatric amputees.
PubMedAn index of healing in below-knee amputation: leg blood pressure by Doppler ultrasound.
112 Citations1976Robert W. Barnes, Gregor D. Shanik +1 more
It is suggested that Doppler ultrasonic assessment of BK arterial signals and pressures may be a simple hemodynamic correlate of healing of a BK amputation.
Journal of Vascular SurgeryResults of lower extremity amputations in patients with end-stage renal disease
98 Citations1994Christos D. Dossa, Alexander D. Shepard +6 more
ESRD has a profound negative impact on morbidity, mortality, and survival rates after LE amputation, and attempts at prevention of amputation with aggressive foot care and patient education in this high-risk group should be the focus of therapy.
Journal of Vascular SurgeryImpact of arterial surgery and balloon angioplasty on amputation: A population-based study of 1155 procedures between 1973 and 1992
92 Citations1997John W. Hallett, John Byrne +4 more
It is concluded that increased vascular surgery and balloon angioplasty rates have coincided with a significant reduction in major amputation rates in the past 10 years.
Annals of Vascular SurgeryMajor Lower Extremity Amputation in an Academic Vascular Center
90 Citations2003Ahmed M. Abou‐Zamzam, Theodore H. Teruya +2 more
Greater than one-half of all major lower extremity amputations are performed in patients who have failed attempts at revascularization or who are not candidates for LER due to anatomic factors, and Prompt patient referral and treatment may improve outcome in this group of patients.
PubMedLower extremity amputation: the control series.
80 Citations1986Blair A. Keagy, John A. Schwartz +3 more
Archives of SurgeryNoninvasive Prediction of Amputation Level in Diabetic Patients
73 Citations1979G. W. Gibbons
In patients undergoing forefoot amputation, segmental systolic pressures were falsely high or predicted incorrectly in over half the cases, and segmental PVRs were correctly predictive in less than one third of the cases.
Journal of Vascular SurgeryOne-stage versus two-stage amputation for wet gangrene of the lower extremity: A randomized study
63 Citations1988Daniel F. Fisher, G. Patrick Clagett +3 more
To examine the issue of wound complications attributable to the amputation technique, 47 patients with necrotizing wet gangrene of the foot were randomized prospectively to receive either a one-stage amputation or a two-stage procedure.
Annals of Vascular SurgeryMajor Lower Extremity Amputation in Veterans Affairs Medical Centers
57 Citations2000Andris Kazmers, Anthony J. Perkins +1 more
The results of this analysis showed that mortality and morbidity rates remain high after AKA and BKA, and Differing amputation practice patterns found in this study warrant further investigation.
Journal of Vascular SurgeryNoninvasive determination of healing of major lower extremity amputation: The continued role of clinical judgment
46 Citations1988Willis H. Wagner, Blair A. Keagy +3 more
It is concluded that the skin temperature and tcPO2 obtained at the site of proposed amputation were the most reliable prognostic noninvasive examinations.
Archives of SurgeryLower-Extremity Amputations for Ischemia
44 Citations1981John M. Porter
The use of prior arterial reconstruction, careful wound care, and willingness to accept nonhealing of trial amputations were important factors in obtaining the most distal possible healed amputation.
PubMedLower extremity amputation for peripheral vascular disease. A low-risk operation.
40 Citations1984T.J. Bunt, Lawrence Manship +2 more
Although lower extremity amputation has a reputation for high mortality and morbidity, this is unwarranted; adherence to a protocol of aggressive medical management with timely surgical intervention allows a mortality that is appropriate to the age and general debility of this patient population.
Journal of Vascular SurgerySkewflap versus long posterior flap in below-knee amputations: Multicenter trial
38 Citations1991C V Ruckley, P A Stonebridge +1 more
It is concluded that the skew flap is just as effective as the long posterior flap and is an excellent option for below-knee amputation.
Archives of SurgeryBelow-Knee Amputation
35 Citations1980John J. Castronuovo
The records of 50 patients undergoing definitive below-knee amputation for ischemia from May 1971 to May 1979 were reviewed and it was found that the patient with marginal circulation and marked preoperative functional limitations may have the above-Knee level as the chosen site for amputation.
PubMedThe fate of the below knee amputee.
16 Citations1983Linda de Cossart, P. Randall +2 more
A retrospective study of patients undergoing 51 below-knee amputations over a six year period on one unit reported an overall success rate of 84.4% and diabetics had equally good results as those patients with peripheral arterial disease.