ORIGINAL ARTICLES   

International Angiology 2002 March;21(1):28-35

Copyright © 2003 EDIZIONI MINERVA MEDICA

lingua: Inglese

The ArtAssist® Device in chronic lower limb ischemia. A pilot study

Louridas G., Saadia R., Spelay J., Abdoh A., Weighell W., Arneja A. S.

From the Section of Vascular Surgery, the Department of Surgery and the Department of Rehabilitation Medicine University of Manitoba, St. Boniface Hospital and Health Sciences Centre, Winnipeg, Manitoba, Canada

Background. Patients with chron­ic crit­i­cal limb ische­mia fol­low­ing a ­failed ­bypass graft or with non-recon­struct­able dis­tal dis­ease diag­nosed angio­graph­i­cal­ly, have a very poor prog­no­sis. This is a pros­pec­tive pilot study to ­assess the influ­ence of the ArtAssist® Device on pedal blood flow and ampu­ta­tion rate.
Methods. Thirty-three legs in 25 ­patients were eval­u­at­ed. Ten legs pre­sent­ed with rest pain, and 23 legs with tis­sue loss. Nine legs had pre­vi­ous­ly under­gone ­bypass sur­gery.
Results. At a mean fol­low-up of 3 ­months, 14 (42%) legs were ampu­tat­ed, and 19 (58%) were saved. Eleven of the ampu­tat­ed legs were in ­patients with chron­ic renal fail­ure, a known risk fac­tor. The ampu­ta­tion rate, exclud­ing this group, was 13.6% (3/22). Toe pres­sures meas­ured initial­ly and after 3 ­months on the pump ­showed a sig­nif­i­cant improve­ment (p=0.03). Forty per­cent of ­patients pre­sent­ing with rest pain ­improved, while 26% of foot ­ulcers ­healed on the pump. Mortality rate was 12%.
Conclusions. The ­results from this pros­pec­tive study are encour­ag­ing but need to be val­i­dat­ed in a larg­er pros­pec­tive ran­dom­ized study.