Abstract
In patients with critical limb ischemia ( CLI ) who have an intractable ulcer of the lower limbs, there is a higher level of need for an amputation due to severe infection after revascularization. Three out of the thirteen patients with CLI ended up with major amputations in the past five years. A comparative study was performed between these patients and those who were cured by only minor amputations. Patient factors in the comparative study included age, sex, medical history of diabetes and chronic kidney disease, diabetes medication, history of lower limb amputation on the other side, complement-reactive protein ( CRP ) levels before and after revascularization and in the early period after local surgery, and serum albumin ( Alb ) before local surgery. The patient risk factors of major amputation were late diabetic nephropathy, history of lower limb amputation on the other side and under-nutrition. There was a possibility of major amputations if patients had high CRP levels early after they completed local surgeries compared with those after revascularization. Perioperative CRP levels may be one of the indicators to use in order to avoid major amputations.
