(CR-032) Success of Limb Salvage in Patients with Peripheral Artery Disease
Co-Author(s):
Amanda Killeen, DPM – Fellow, Plastic Surgery, UT Southwestern Medical Center; Dane Wukich, MD – Professor and Chair, Orthopedic Surgery, UT Southwestern. Medical Center; Lawrence Lavery, DPM, MPH – Professor, Plastic Surgery, UT Southwestern Medical Center
<b>Introduction</b>: <p class="MsoNormal"><span style="font-size: 11.0pt; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: Helvetica; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; color: black; mso-themecolor: text1;">To e</span><span style="font-size: 11.0pt; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; color: black; mso-themecolor: text1;">valuate limb salvage success rate in patients undergoing transmetatarsal amputation, to determine if there is a difference in limb salvage success rate in patients with anterior tibialis artery versus posterior tibialis artery versus peroneal artery runoff to the foot, and to determine if there is a difference in single vs two vessels runoff in limb salvage outcome</span></p><br/><br/><b>Methods</b>: <p class="MsoNormal"><span style="font-size: 11.0pt; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; color: black; mso-themecolor: text1;">This was a 10 years (2010-2020) retrospective review of all patients who presented to the author healthcare system, underwent a TMA, and had an angiogram or computed tomography angiography (CTA) done perioperatively. There were no exclusion criteria. </span></p><br/><br/><b>Results</b>: <p class="MsoNormal"><span style="font-size: 11.0pt; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; color: black; mso-themecolor: text1;">There was a total of 125 TMA performed between 2010-2020 at the institution. Forty-four (35.2%) patients had an angiogram/CTA peri-operative; 29 (23.2%) patients had an ankle-brachial index (ABI) done peri-operative; and 52 (41.6%) patients had no vascular study done. Forty-four patients met the inclusion criteria, of which, there were 17 (38.6%) failure. Of the 17 failure, 2 (11.8%) patients had no patent vessel runoff to the foot, 9 (52.9%) patients had one vessel, 4 (23.5%) patients had two vessels, and 2 (11.8%) patients had three vessels runoff. </span></p><br/><br/><b>Discussion</b>: <p class="MsoNormal"><span style="font-size: 11.0pt; font-family: 'Calibri',sans-serif; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; color: black; mso-themecolor: text1;">One vessel runoff to the foot yielded a highly poor outcome with 56.3% of resulted in a higher level of amputation. Two or more vessels runoff to the foot will have over 75% success rate of limb salvage with a TMA.<span style="mso-spacerun: yes;"> </span>Tarsal and Pedal Arch filled may play an important role in healing.</span></p><br/><br/><b>Trademarked Items</b>: <br/><br/><b>References</b>: <br/><br/>