Abstract

The aim of this work was to analyze the results of the management of acute lower limbischemia. Materials and methods : It was a retrospective study for 12 years (2000 -2011) at teaching hospital Point “G” Bamako. The medical files and the operational reports of the patients dealt with for acute arterial ischemia of the lower limb were re-examined. Results: We managed 50 patients for an acute lower limb ischemia.There were 68% (n=34) men for 32% (n=16) women. The mean age was 59 years ± 23 years. The median interval with the surgical consultation was 37 days. The same cardiovascular risk factors were tobacco 44% (n=22), HTA 42% (n=21), diabetes 16% (n=8). In surgical consultation (n=44) 88% of the patients had already a gangrene of the lower limb. Echo-Doppler was carried out at 88% of the patients (n=44). According to the classification of Rutherford there were 88% of class III (n=44) and 12% of class II B (n=6). The site of occlusion were popliteal artery in 38% (n=19), leg arteries 30% (n=15), femoral artery 28% (n=14). The major etiologic mechanisms of arterial ischemia were an embolism in 50% (n=25) whose cardiac cause was found at 22% (n=11), a thrombosis in 50% (n=25). Acute ischemia had occurred on an arteriopathy obliterating chronic at 31 patients (62%). Only 3 patients (6%) of the patients had profited from a heparin therapy before the surgical consultation. Initial amputation was carried out at 31 cases (66%), a thrombo-embolectomy with the catheter of Fogarty in 4 patients (8,5%), embolectomy with Fogarty procedure associated to an amputation in 25,5% (n=12) and secondary amputation in 3 cases (6,5%). The outcomes were simple in 91,5% of our patients (n=43). Overall mortality was 8% (n=4). Conclusion: An early diagnosis and an early therapeutic associate to an adapted technical structure can improve our results.

Key words: Acute - ischemia-lower limb - surgery