Immediate results of conservative treatment of patients with unreconstructable critical limb ischaemia and trophic changes

Chervyakov Yu.V.¹, Kha Kh.N.², Klimova.E.², Gavrilenko A.V.^3,4

1) Yaroslavl State Medical University of the FR Ministry of Public Health, Yaroslavl,
2) Russian University of Friendship of Peoples,
3) Russian Research Centre of Surgery named after Academician B.V. Petrovsky,
4) First Moscow State Medical University named after I.M. Sechenov under the RF Ministry of Public Health, Moscow, Russia

The purpose of the study was to comparatively assess efficacy of using agents belonging to the group of prostaglandin E1 in comprehensive conservative treatment of patients with unreconstructable critical limb ischaemia and trophic changes by the frequency of major amputation, amputation-free survival, and total mortality by combinations of the WIfI classification during a 6-month follow up period.

Our retrospective multicentre study enrolled a total of 109 patients, including 60 men and 49 women, with a mean age of 70±7.3 years. The patients were subdivided into 2 groups. Group 1 patients (n=58) received standard conservative therapy without prostaglandin E1 and group 2 patients (n=51) received similar treatment with the use of prostaglandin E1. The statistical analysis (chi-squared test, Fisher criterion, log-rank test) was carried out with regard to stratification of the patients in the groups by the WIfI component combinations.

No statistically significant differences between the groups in the frequency of amputation and total mortality were revealed (p=0.094 and p=0.925, respectively). The use of the WIfI classification system made it possible to single out a cohort of patients (with a WIfI combination of 130) for whom the results of administering prostaglandin E1 statistically significantly differed by the frequency of amputation (p=0.042) and by amputation-free survival (p=0.017). No significant differences by these outcomes were obtained for other combinations analysed.

A conclusion was drawn that using prostaglandin E1 in comprehensive conservative treatment decreased the frequency of amputation and increased amputation-free survival in patients presenting with unreconstructable critical limb ischaemia and referred to the category with a combination of 130 according to the WIfI classification.

KEY WORDS: critical lower limb ischaemia, conservative therapy, WIfI classification, prostaglandin E1.

P. 16

« Back