Abstract

  Atherosclerosis is the most common arterial damage characterized by blood clotting due to the local thickening of the intima that is called atheroma or plaque. It is usually not diagnosed until critical stenosis, thrombosis, aneurysm or emboli occur. If severe artery clogging occurs, there is high risk for lower extremities, where gangrene appears to be the major consequence that has to be surgically treated by an amputation treatment. This study is a retrospective comparative study that includes 124 patients, both genders, of different age groups. The aim of the study is to show the effects of amputation procedures with the lowest complication rate due to lower extremity vascularization.

  This study has shown that atherosclerotic and diabetic changes of the blood vessels of the lower extremities are more common in male gender, in the third age range where clogging is most often verified on the pedal arteries causing the gangrene of the toes. The most common surgical procedures are amputation of the toes with the most common complication defined as edge inflammation, while the lowest number of local complications was observed in the lower and upper leg amputations.

  Since it has been proven that advanced atherosclerosis cannot fully regenerate, the goal of the treatment is to reduce the effect of the disease through prevention. Special attention should be made to male gender in third age range with comorbidities, and if the need for surgical treatment becomes necessary, it is to be realized in accordance with the findings of the blood flow rate at the lower extremities without delay.

Keywords: Atherosclerosis; Diabetes; Blood Flow Rate; Prevention; Amputation

References

1. Beckman JA., et al. “Microvascular Disease, Peripheral Artery Disease, and Amputation”. Circulation6 (2019): 449-458.
2. Ramczykowski T and Schildhauer TA. “Amputation und Prothesenversorgung – die untere Extremität [Amputation of the Lower Limb - Treatment and Management]”. Zeitschrift fur Orthopadie und Unfallchirurgie 4 (2017): 477-498.
3. Varma P., et al. “Epidemiology of limb loss”. Physical Medicine and Rehabilitation Clinics of North America 1 (2014): 1-8.
4. Berli MC., et al. “Predictors for reoperation after lower limb amputation in patients with peripheral arterial disease”. Vasa 5 (2019): 419-424.
5. Mustapha JA., et al. “Determinants of Long-Term Outcomes and Costs in the Management of Critical Limb Ischemia: A Population-Based Cohort Study”. Journal of the American Heart Association 16 (2018): e009724.
6. Fard B., et al. “Mortality, Reamputation, and Preoperative Comorbidities in Patients Undergoing Dysvascular Lower Limb Amputation”. Annals of Vascular Surgery 64 (2020): 228-238.
7. Hussain MA., et al. “Population-based secular trends in lower-extremity amputation for diabetes and peripheral artery disease”. Canadian Medical Association Journal 35 (2019): E955-E961.
8. Reinecke H., et al. “Peripheral arterial disease and critical limb ischaemia: still poor outcomes and lack of guideline adherence”. European Heart Journal 36 (2015): 932-938.
9. Kroger K., et al. “Lower Limb Amputation in Germany”. Deutsches Ärzteblatt International 114 (2017): 130-136.
10. Swaminathan A., et al. “Lower extremity amputation in peripheral artery disease: improving patient outcomes”. Vascular Health and Risk Management 10 (2014): 417-424.
11. Mills JL. “The application of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification to stratify amputation risk”. Journal of Vascular Surgery 3 (2017): 591-593.
12. Malyar NM., et al. “Amputations and mortality in in-hospital treated patients with peripheral artery disease and diabetic foot syndrome”. Journal of Diabetes and Its Complications 30 (2016): 1117-1122.
13. Narula N., et al. “Pathology of Peripheral Artery Disease in Patients with Critical Limb Ischemia”. Journal of the American College of Cardiology 18 (2018): 2152-2163.
14. Spoden M., et al. “Amputation rates of the lower limb by amputation level - observational study using German national hospital discharge data from 2005 to 2015”. BMC Health Services Research 1 (2019): 8.

Citation

Citation: Edina Tanović., et al. “Amputation Treatment with Least Number of Postoperative Complications based on the Atherosclerotic and Diabetic Changes of Blood Vessels of Lower Extremities". Acta Scientific Medical Sciences 4.11 (2020): 66-69.

Copyright

Copyright: © 2020 Edina Tanović., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.