Stent-Assisted Recanalisation of Acute Occlusive Arteries in Patients with Acute Limb Ischaemia

Abstract

Objective: To assess the efficacy of stent-assisted recanalisation for acute limb ischaemia in patients considered unfit for thrombolysis or in patients with failed surgical recanalisation. Materials and Methods: Fifteen patients with acute limb ischaemia, treated with stent implantation, were analysed retrospectively. The reasons for acute limb ischaemia were a cardiogenic embolism (n = 3), a traumatic injury (n = 3), acute in situ thrombosis with atherosclerosis (n = 6), immediate graft thrombosis (n = 2), or a delayed thrombotic occlusion after a thrombin injection in the pseudoaneurysm (n = 1). This study examined the technical and clinical outcomes of the procedures, including complications during the procedural and follow-up periods. Results: Stent-assisted recanalisation was technically successful and provided immediate recanalisation in all patients (15/15 patients, 100%) and reduced or eliminated the clinical symptoms in 12 patients (12/15 patients, 80%). Two patients died of multi-organ failure related to reperfusion injury, and one patient with a crash injury underwent a below-the-knee amputation as a result of wound necrosis despite recanalisation of the occluded bypass graft. Conclusions: Stent-assisted recanalisation has a high technical success rate with good clinical results as a bailout procedure for the management of acute limb ischaemia in patients, considered unfit for thrombolysis or in patients with failed surgical recanalisation. (C) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.