Keywords
chronic limb-threatening ischemia
repeat revascularization
open vascular surgery
ankle-brachial index
limb salvage
How to Cite
Abstract
Introduction. Occlusive-stenotic lesions of the lower extremity arteries may progress to chronic limb-threatening ischemia, limb loss, and marked functional impairment. Reocclusion after primary revascularization requires an individualized choice of repeat treatment.
Aim. To assess the clinical results of repeat open revascularization procedures in patients with occlusive-stenotic lesions of the lower extremity arteries.
Materials and methods. This retrospective single-centre study was conducted from 2022 to 2025. The treatment outcomes of 119 patients undergoing lower-extremity revascularization were reviewed. The analytic cohort comprised 70 patients who underwent 71 repeat open procedures: 10 women (14.3%) and 60 men (85.7%), with a mean age of 63.5 ± 10.7 years. The causes of repeat revascularization, ankle-brachial index, pain-free walking distance, postoperative complications, amputations, and length of hospital stay were assessed.
Results. Outflow disease was the predominant reason for repeat revascularization (46/70, 65.7%), followed by early thrombosis of the reconstructed segment (13/70, 18.6%). Non-adherence to prescribed medical therapy after primary intervention was reported by 25/70 (35.7%) patients. At one-year follow-up, the ankle-brachial index increased from 0.308 ± 0.064 to 0.919 ± 0.036, and pain-free walking distance increased from 48.06 ± 57.9 to 907.86 ± 228.2 m (p < 0.001). Postoperative complications occurred in 9/70 (12.9%) patients. During follow-up, 27/70 (38.6%) patients underwent amputation, including 21 during the first year. The mean hospital stay was 9.18 ± 2.06 days.
Conclusions. In selected patients, repeat open revascularization was associated with substantial improvement in limb perfusion and walking capacity. The high amputation rate reflects the severity of the underlying arterial disease and supports comprehensive preoperative risk stratification, assessment of distal runoff, structured surveillance, and adherence to secondary preventive therapy.
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