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A Preventable Cause of Increased Mortality

John A. Strom, MD; Victor M. Bernhard, MD; Jonathan B. Towne, MD

Arch Surg. 1984;119(4):470-473.

Abstract
• Acute limb ischemia following aortic reconstruction is primarily related to intraoperative technical errors and is associated with significantly increased mortality. Elective aortic reconstruction was performed on 262 patients between 1975 and 1981. Surgical indications were aneurysm in 84 patients (32%), occlusive disease in 125 (48%), and both of these in 53 (20%). Acute limb ischemia developed postoperatively in 27 patients (10.3%); it was noted at the conclusion of the operation in five (19%) of them and within the first 48 hours in 22 (81%). The mortality was greater in the combined aneurysm and occlusive disease group than in the aneurysmonly and occlusive disease—only groups, primarily because of an increased incidence of myocardial disease in the combined group. Postoperative limb ischemia was mainly a result of technical error and resulted in increased mortality in all groups.

(Arch Surg 1984;119:470-473)

Author Affiliations
From the Medical College of Wisconsin, Milwaukee, and the Veterans Administration Medical Center, Wood, Wis.

Footnotes
Accepted for publication Nov 21, 1983.

Read before the Seventh Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Airlie, Va, May 28, 1983.

Reprint requests to Department of Surgery, Medical College of Wisconsin, 8700 W Wisconsin Ave, Milwaukee, WI 53226 (Dr Towne).

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