15:45 Uhr
FV-27:
Acute limb ischemia in patients with neoplastic disease / Akute Extremitätenischämie bei Patienten mit Neoplasien
Dr. med. Angeliki Argyriou | St. Franziskus-Hospital, Münster | Germany
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Autor:innen:
Dr. med. Angeliki Argyriou | St. Franziskus-Hospital, Münster | Germany
Dr. Efthymios Beropoulis | St. Franziskus-Hospital, Münster | Germany
Priv.-Doz Theodosios Bisdas | Athens Medical Center | Greece
Prof. Dr. med. Giovanni Torsello | St. Franziskus-Hospital, Münster | Germany
Priv-Doz. Dr. med Konstantinos Stavroulakis | Uniklinikum Muenster | Germany
Introduction: Acute limb ischemia (ALI) can be a devastating complication in patients with neoplastic disease. The current advances in both medical and endovascular field have the potential to improve the clinical outcomes in this challenging cohort.
Objectives: To assess the performance of surgical and endovascular procedures in patients with ALI and malignant diseases.
Methods: We retrospectively analyzed cases of acute lower limb ischemia as manifestation of an underlying malignant process treated by either surgical or endovascular procedures between 2011 and 2018. Primary endpoint of this study was amputation-free-survival. Amputation free time and overall survival were additionally evaluated.
Results: Twenty-nine (n=29) patients (male 13/29, 44.8%) were identified. In 7 cases (24.1%) ALI war the first manifestation of the underlying disease. In 7 patients a colorectal/visceral cancer (24.1%) was diagnosed, while in 8 (27.5%) subjects a malignancy of the lungs was the underlying cause of the thromboembolism. The majority of patients (17/29, 62%) presented with an acute onset of symptoms of less than 24 h and did not have any previous lower extremity interventions in their medical history. The severity of limb ischemia was classified as Rutherford IIa in fourteen patients (48.3%) and as Rutheford IIb in twelve patients (41.3%). Conventional thromboembolectomy was performed in nineteen patients. The rest of the patients (10/29, 34.48%) were treated with percutaneous mechanical thrombectomy with or without adjunctive catheter-directed thrombolysis.
The overall survival amounted to 56% and 44% at 6 and 12 months respectively. Freedom of amputation was 89% after 6 and 12 months. Amputation free survival was 54% and 41% at 6 and 12 months respectively.
Conclusion: Despite the current developments in both medical and endovascular field, ALI in patients with neoplastic diseases is still associated with significant morbidity and mortality and low rates of amputation free survival.