The outcome of acute occlusion of the abdominal aorta with bilateral limb ischaemia

Denis Skrypnik; Sultan Butaev; Artur Arakelyan; Coral Falco; Roman Vinogradov; Alexander Baryshev; Vladimir Porhanov

doi:10.1016/j.heliyon.2022.e12440

The outcome of acute occlusion of the abdominal aorta with bilateral limb ischaemia

Heliyon. 2022 Dec 23;8(12):e12440. doi: 10.1016/j.heliyon.2022.e12440. eCollection 2022 Dec.

Authors

Denis Skrypnik¹, Sultan Butaev², Artur Arakelyan², Coral Falco³, Roman Vinogradov^{1

2}, Alexander Baryshev^{1

2}, Vladimir Porhanov^{1

2}

Affiliations

¹ Kuban State Medical University, Krasnodarskij Kraj, Krasnodar, Russia.
² Professor S. V. Ochapovsky Regional Clinical Hospital No 1, Department of Vascular Surgery, Krasnodarskij Kraj, Krasnodar, Russia.
³ Western Norway University of Applied Sciences, Culture and Sport, Bergen, Hordaland, Norway.

Abstract

Background: The purpose of this study was to investigate if the duration of bilateral acute limb ischaemia (BALI) caused by acute aortic occlusion (AAO) affected amputation-free survival.

Materials and methods: A retrospective analysis of patients treated between 1 January 2010 and 1 January 2019 for primary occlusion of the infrarenal aorta and BALI was performed. Univariate analysis was used to determine the risk factors for adverse outcomes and compare the duration of BALI between the amputation-free survival and non-amputation-free survival groups.

Results: The data from 16 patients with a mean age of 70 ± 11 years were analysed. Predominantly females (56.3%, 9/16) were included in the study. Out of 16 patients, nine had Rutherford grade IIb, and seven had Rutherford grade III at admission. Seven patients underwent revascularisation attempts, two underwent primary major amputation, and seven underwent primary palliation. The mean ischaemia time was significantly shorter in the amputation-free survival group than in the non-amputation-free survival group (7.4 ± 3.5 h vs 22.4 ± 16.3 h, p = .01). The time frame for successful bilateral lower limb revascularisation was <11 h (p = .03).

Conclusions: The duration of BALI due to AAO of <11 h was shown to be associated with improved amputation-free survival.

Keywords: Acute aortic occlusion; Acute limb ischaemia; Amputation-free survival; Bilateral limb ischaemia; Ischaemia time.