RESUMO
BACKGROUND: The prevalence and treatment of peripheral arterial disease in the Caribbean is not well documented. The aim of this study was to review the results from a small hospital in the Caribbean. METHODS: One-hundred and eight infra-inguinal arterial reconstructions on 90 patients were retrospectively reviewed Patients were classified according to the categories suggested by the Ad Hoc Committee on Reporting Standards of the Joint Councils of the Society for Vascular Surgery. Follow-up ranged from 0 to 103.1 months. The Kaplan-Meier method was used to visualize survival, limb salvage rates and primary and secondary patency rates. Cox regressions were used to identify potential risk factors. RESULTS: The limb salvage rates were 74.5% after one year and 71.4% after five years. Overall primary patency rates were 67.0 % after one year, 63.4% after three years and 50.8 % after five years. Overall secondary patency rates were 86.4% after one year and 75.1% after five years. The primary patency rate for autologous saphenous vein was 82.4% (SE 7.5%) after five years. The primary patency rates for prosthetic grafts were 62.1% (SE 8.5%) after one year; 56.9% (SE 9.2%) at three years and 37.9% (SE 16.7%) after five years. CONCLUSION: Infra-inguinal arterial bypass surgery is feasible in small Caribbean hospitals showing results comparable to major studies.
ANTECEDENTES: La prevalencia y el tratamiento de enfermedad arterial periférica en el Caribe no están bien documentados. El objetivo de este estudio fue examinar los resultados de un pequeño hospital en el Caribe. MÉTODOS: Se examinaron retrospectivamente ciento reconstrucciones arteriales infrainguinales en 90 pacientes. Los pacientes eran clasificados según las categorías sugeridas por el Comité Ad Hoc para el Reporte de Normas de los Consejos Unidos de la Sociedad de Cirugía Vascular. El seguimiento tuvo un rango de 0 a 103.1 meses. Se usó el método Kaplan-Meier con el objeto de ver las tasas de super-vivencia, salvamento de la extremidad, y tasas primarias y secundarias de permeabilidad. Se usaron regresiones de Cox para identificar los factores de riesgo potencial. RESULTADOS: Las tasas de salvamento de miembro fueron 74.5% después de un año y 71.4% después de cinco años. Las tasas generales de permeabilidad primaria fueron 67.0% después de un año, 63.4% después de tres años y 50.8% después de cinco años. Las tasas generales de permeabilidad secundaria fueron 86.4% después de un año y 75.1% después de cinco años. La tasa de permeabilidad primaria para la vena safena autóloga fue 82.4% (SE 7.5%) después de cinco años. Las tasas de permeabilidad primaria para los injertos prostéticos fueron 62.1% (SE 8.5%) después de un año, 56.9% (SE 9.2%) a los tres años y 37.9% (SE 16.7%) después de cinco años. CONCLUSIÓN: La cirugía de bypass arterial infrainguinal es factible en hospitales caribeños pequeños que muestran resultados comparables a los de estudios importantes.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/cirurgia , Procedimentos de Cirurgia Plástica , Resultado do Tratamento , Antilhas Holandesas/epidemiologia , Grau de Desobstrução Vascular , Doenças Vasculares Periféricas/epidemiologia , Estudos Retrospectivos , Medição de Risco , Prevalência , Salvamento de Membro , Veia Safena/cirurgiaRESUMO
BACKGROUND: The prevalence and treatment of peripheral arterial disease in the Caribbean is not well documented. The aim of this study was to review the results from a small hospital in the Caribbean. METHODS: One-hundred and eight infra-inguinal arterial reconstructions on 90 patients were retrospectively reviewed Patients were classified according to the categories suggested by the Ad Hoc Committee on Reporting Standards of the Joint Councils of the Society for Vascular Surgery. Follow-up ranged from 0 to 103.1 months. The Kaplan-Meier method was used to visualize survival, limb salvage rates and primary and secondary patency rates. Cox regressions were used to identify potential risk factors. RESULTS: The limb salvage rates were 74.5% after one year and 71.4% after five years. Overall primary patency rates were 67.0 % after one year, 63.4% after three years and 50.8 % after five years. Overall secondary patency rates were 86.4% after one year and 75.1% after five years. The primary patency rate for autologous saphenous vein was 82.4% (SE 7.5%) after five years. The primary patency rates for prosthetic grafts were 62.1% (SE 8.5%) after one year; 56.9% (SE 9.2%) at three years and 37.9% (SE 16.7%) after five years. CONCLUSION: Infra-inguinal arterial bypass surgery is feasible in small Caribbean hospitals showing results comparable to major studies.