Low Rates of Revascularization and High In-Hospital Mortality in Patients With Ischemic Lower Limb Amputation

Abstract

The total number of ischemic LLA and amputation-related in-hospital mortality remains high in Germany in the 21st century. The poor outcome of patients with CLI might in part be due to underuse of revascularizations prior to amputation.

Lower Limb Amputation in Germany

“…For instance, analysis of a German health insurance fund's data for the period 2009 to 2011, which permitted case-related evaluation, showed that in 37% of inpatients with chronic critical ischemia treated with amputation, neither angiography nor attempted revascularization was documented in the 24 months before surgery (31,32). There is thus an urgent need for clarification of how, and on what basis, the decision to amputate is arrived at in each individual patient.…”

The relationship between acute arterial occlusions and the stage of peripheral arterial disease according to the Fontaine Classification

“…Atherosclerosis is the most frequently encountered etiology followed by vasculitis, dysplastic syndromes, degenerative diseases, thrombosis, and thromboembolism. The mortality rate at diagnosis is 4%-6% (1).…”

PAVK der unteren Extremitäten – konservative und antithrombotische Therapie

“…Bundesweit sank die Rate der Majoramputation in den letzten 10 Jahren um etwa 30 %; allerdings stieg die Rate an Minoramputationen im gleichen Zeitraum um 25 % an [2]. Die peri-und postoperative Letalität bei Minoramputationen liegt bei 4,6 %, während die mit Majoramputationen assoziierte Letalität mit 19,8 % deutlich erhöht ist [3].…”