Characteristics of patients who underwent lower limb amputation due to critical limb ischemia – one center experience

Introduction. The aim of this study is to analyze the characteristics of patients in whom leg amputation was performed due to critical limb ischemia (CLI).Material and methods. Retrospective analysis of the characteristics of patients who underwent leg amputation between 2012 and 2014 in our center.Results. Between 2012 and 2014, 39 amputations of 37 limbs were performed on 32 patients treated due to CLI. Amputations amounted to 39/1282 (3.2%) of all vascular procedures performed on the lower limbs. They concerned, respectively: forefoot – 49%, calf – 15%, and thigh – 36%. In 85% of patients, the amputations were preceded by vascular procedures. The median length of time between the first revascularization procedure and amputation amounted to 99 ± 8-1088 days. Patients who underwent primary amputation (n = 6, 15%) compared to the individuals with secondary amputation were treated less frequently with aspirin (67% vs. 97%; p = 0.01) and statins (50% vs. 94%, p = 0.002). Patients who underwent amputation at thigh level compared with subjects with forefoot amputation were hospitalized for a significantly longer period of time, diagnosed more often with chronic heart failure (CHF) and chronic kidney disease (CKD), and were more often tobacco smokers.Conclusions. The main factors determining the need for amputation, its level and time between the first revascularization procedure and leg amputation were: the number of preceding procedures and stent implantations, comorbidity of CHF and CKD, smoking habit, inadequate pharmacotherapy (probably due to delayed diagnosis), severity of angiographic lesions, and higher MPV and INR values.