Inevitable Endpoint in Peripheral Arterial Disease: Extremity Amputations

Objective: Limb amputations affect individuals" economic and psychosocial lives significantly regardless of the amputation level. Amputations are most frequently done due to peripheral vascular diseases and trauma. We aimed to investigate the lower extremity amputation cases performed due to peripheral vascular disease in our clinic. Material and Methods: A total of 853 patients operated for peripheral vascular diseases between January 2003 and January 2014 were included in the study. An extremity amputation was performed in 95 (11.1%) of these patients. Patients with peripheral arterial disease were analyzed for smoking, diabetes mellitus and other systemic diseases. The level of amputation was determined taking the demarcation line into account. Results: The mean age of the patients was 66±8.1 years (males 66.2 ± 8.2, females 62.8±4.7 years), 94.7% (n=90) of them were males, and 5.3% (n=5) of them were females. In 23.3% (n=22) of patients amputation was performed at ankle level or more distally, in 35.7% (n=34) of the patients amputation was performed below the knee level, and in 41% (n=39) of them amputation was performed above the knee level. The mean duration of hospital stay was 11.9±5.8 days. Mortality occurred in 3 patients (3.2%) after amputation due to cardiac causes. Re-amputation was necessary in 4 patients (4.2%) due to stump necrosis. Conclusion: Despite use of new grafts, endovascular interventions, and advanced surgical techniques, the amputations are still important particularly in the peripheral arterial diseases. It should be noted that revascularization in an ischemic or traumatic condition may result in life -threatening conditions due to ischemia-reperfusion injury. It has been generally accepted that amputations made in proper time and with proper indications are life saving.