skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8838

Axillofemoral bypass with local anesthesia: a way forward to enable limb salvage in high-risk patients

Case Series

(1353) Views  (430) Full article downloads

Authors: Abdullah Al-Wahbi

Published Date October 2010 Volume 2010:3 Pages 129 - 132
DOI: http://dx.doi.org/10.2147/LRA.S13928

Abdullah Al-Wahbi
Department of Vascular Surgery, King Abdulaziz Medical City, Vascular Surgery Division, Riyadh, Saudi Arabia

Abstract: For an active, ambulant patient with critical, lower limb ischemia, amputation can lead to a poor quality of life. A small group of older people with critical limb ischemia are considered at high risk for revascularization under conventional anesthesia owing to their comorbid conditions. In these cases, when endovascular therapy is not an option, the decision to amputate or revascularize presents a dilemma, especially in ambulant patients. In this article, we present 2 cases in which the individuals had diabetic foot gangrene, rest pain, and multiple comorbidities, and were unfit to undergo conventional anesthesia. In addition, they had severe aortoiliac occlusive disease, which cannot be managed by endovascular methods. Both patients were living independently and were ambulant before their foot ulcer and ischemia. They underwent an axillofemoral bypass under local anesthesia. The postoperative course was uneventful. After a 3-year follow-up, both patients continue to be ambulant and have no complaints. With selective use of local anesthetic techniques, surgical teamwork to shorten the procedure time, and close meticulous postoperative care, an axillofemoral bypass can enable limb salvage for ambulant patients who are considered unfit for conventional anesthesia.

Keywords: limb salvage, axillofemoral bypass, local anesthesia, high-risk patients




 

Other articles by Dr Abdullah Alwahbi



Readers of this article also read:

Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors
The treatment of diabetic foot infections: focus on ertapenem
Retinal nerve fiber layer thickness in recovered and persistent amblyopia
Wearing facemasks when performing lumbar punctures: a snapshot of current practice amongst trainee doctors
Solid self-nanoemulsifying cyclosporin A pellets prepared by fluid-bed coating: preparation, characterization and in vitro redispersibility
The relationship between deliberate self-harm behavior, body dissatisfaction, and suicide in adolescents: current concepts
Zinc oxide nanoparticles as selective killers of proliferating cells
Cumulative clinical experience from over a decade of use of levofloxacin in community-acquired pneumonia: critical appraisal and role in therapy
Evaluation of analgesic efficacy of bromfenac sodium ophthalmic solution 0.09% versus ketorolac tromethamine ophthalmic solution 0.5% following LASEK or Epi-LASIK
Primary care for diabetes mellitus: perspective from older patients