Key Risk Factors for Early Postoperative Complications Following Different Revascularization Techniques in Acute Limb Ischemia

Introduction: acute limb ischemia is characterized by a sudden and severe reduction in blood supply to the limb, posing a critical threat to its viability. The incidence of complications associated with ALI remains significantly high. Currently, there is no consensus regarding which preoperative factors influence the incidence of complications in different revascularization methods, nor to what extent they contribute to postoperative outcomes. An analysis of the key predictors of complications will facilitate the development of preventive strategies and establish criteria for selecting the most appropriate treatment approach for ALI. Materials and methods: this study analyzes the outcomes of two treatment methods for ALI classified as Rutherford class II: open surgical intervention (Group I, n = 50) and endovascular procedures (Group II, n = 50). Results and discussion: the composition and impact of preoperative risk factors differed between the two revascularization methods. In the open surgery group, patients with an inflammatory, hypovolemic, or thrombophilic etiology of ALI (11) demonstrated a higher likelihood of an unfavorable postoperative course. Additionally, advanced patient age (7.1), Rutherford ischemia class IIB (0.2), a history of CAD (6.1), DM (9.2), CKD (12.1), and RF (8.5) were identified as significant risk factors for postoperative complications. In the endovascular revascularization group, among perioperative risk factors, the following variables demonstrated significant associations with postoperative complications: CAD (4.9), CKD (12.4), DM (5.28), RF (11), and Rutherford ischemia class IIB (0.2). Conclusion: selecting an appropriate revascularization method based on an individualized risk factor profile for each patient can effectively reduce the incidence of complications in the early postoperative period.