Outcomes of Acute Limb Ischaemia in Patients with Underlying Malignancy: A Systematic Review.
Acute limb ischaemia
Cancer
Malignancy
Revascularisation
Vascular surgery
Journal
EJVES vascular forum
ISSN: 2666-688X
Titre abrégé: EJVES Vasc Forum
Pays: England
ID NLM: 101766732
Informations de publication
Date de publication:
2022
2022
Historique:
received:
10
01
2021
revised:
20
09
2021
accepted:
28
10
2021
entrez:
3
1
2022
pubmed:
4
1
2022
medline:
4
1
2022
Statut:
epublish
Résumé
Previous studies have demonstrated amputation and mortality rates to be 14.3% - 30% and 11.4% - 28.9%, respectively, for all patients presenting with acute limb ischaemia (ALI). Rates of ALI are higher in patients with malignancy than in those without. Despite this, there remains uncertainty with regards to the most appropriate management for patients with cancer presenting with ALI. This is because of previously published high rates of associated morbidity and mortality in this population. The aim of this review was to summarise the available evidence reporting on outcomes of ALI in patients with underlying malignancy. A systematic review was performed in August 2020 in accordance with the PRISMA guidelines. The Medline, Scopus, Cochrane, and Embase databases were searched with the following search string ((acute limb ischaemia) OR (acute limb ischemia)) AND ((cancer) OR (malignancy)). A total of 849 papers were identified and reviewed; six studies were included. Studies were assessed for bias using the National Institute of Health/National Heart, Lung and Blood Institute Quality Assessment Tool. Data including demographics, Rutherford classification, baseline performance scores, method of revascularisation, and peri-procedural outcomes were extracted and analysed. Data were pooled based on outcomes of interest and pooled prevalence was reported with 95% confidence intervals (CI). Six studies with 284 patients with cancer were included for analysis. The pooled overall risk of amputation was 15% (95% CI 5.9 - 26.9). The pooled 30 day mortality rate was 24% (95% CI 14.7 - 34.6). Despite limitations of interstudy selection bias and some clinical heterogeneity, the included studies demonstrated acceptable short and medium term outcomes for patients with cancer undergoing revascularisation for acute limb ischaemia. This is in line with current recommendations that patients with underlying malignancy should be considered strongly for revascularisation.
Identifiants
pubmed: 34977837
doi: 10.1016/j.ejvsvf.2021.10.019
pii: S2666-688X(21)00058-7
pmc: PMC8685981
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
13-20Informations de copyright
© 2021 Published by Elsevier Ltd on behalf of European Society for Vascular Surgery.
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