Abstract

GOUVEIA, Ricardo et al. Amputation and the limits of lower limb revascularization: analyses of 3 years in a surgical center. Angiol Cir Vasc [online]. 2012, vol.8, n.4, pp.162-172. ISSN 1646-706X.

Introduction: Revascularization, both endovascular or open surgery, is the treatment of choice in critical limb ischemia. New tools are being developed that allow us, on one hand, to ensure a more prolonged therapeutic success and, on the other hand, to treat vascular sectors that were previously though inaccessible. Successful treatments do not always occur with immediate improvement of autonomy and ability to walk and there may be a perpetuation of a convalescence state and a loss in the rehabilitation. Amputation, including major, is often seen as a failure. It may, however, represent a definitive treatment for a chronic state causing prolonged suffering, sometimes more disabling itself. Faced with a future outlook of almost limitless possibilities for revascularization, when shall we, vascular surgeons, give up this form of treatment and amputate? Methods and Discussion: We performed a retrospective assessment of the last 3 years of experience in amputations performed in the department of Angiology and Vascular Surgery of our hospital, as well as a comparative analysis of patients previously revascularized and non-revascularized. We applied a questionnaire of quality of life to the group that underwent major amputations, in order to determine whether the previous revascularization represented an increase in the quality of life. This work allows us to reflect on situations in which revascularization was unceasingly pursued and major amputation continually rejected. It behooves us, vascular surgeons, knowing our target population, making this reflection and trying to coordinate a multidisciplinary treatment of amputees so that they can benefit of the best possible rehabilitation.

Keywords : amputation; revascularization; quality of life.

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