1239 Morbidity and Mortality Following Salvage of Acute Limb Ischaemia

Aim Beyond short-term technical results, the wider clinical impact of Acute Limb Ischaemia (ALI) is not well described in the literature. This study aims to establish the outcomes following surgical thromboembolectomy for ALI, with specific reference to amputation-free survival and 12-month survival. Method A retrospective review of all patients who underwent surgical thromboembolectomy, 01/01/2019 – 01/01/2022. Patients were identified from our unit database and their EPR interrogated with a follow-up period of 12 months. Patients with known established peripheral arterial disease, or cases of acute-on-chronic ischaemia were excluded. Results 81 patients met the inclusion criteria (38 male vs 43 female). The median age was 78 (IQR 53-85), with a median clinical frailty score of 4 (IQR 3-5). Patients were grouped according to their presenting symptoms using the Rutherford classification for ALI, and 57% were presenting with immediately threatened limb (Class IIb). Successful revascularisation was established in 74 patients; 5 of these still progressed to major limb amputation (MLA), while 4 of 7 failed revascularisations resulted in MLA. Overall, 12-month amputation-free survival was achieved in 72 patients. 30-day MACE (including pulmonary embolism) occurred in 11 cases and 30-day mortality was seen in 7 cases. All-cause mortality was seen in 24 of 81 patients at 12 months. Conclusions Acute limb ischaemia carries significant morbidity and mortality despite surgical success for many. A greater understanding of longer-term outcomes should aid patient counselling.