Major amputation following vascular reconstructive procedures (including sympathectomy).

To study the effects of vascular reconstruction or sympathectomy, or both, on the level of amputation, the number of revision procedures performed and the mortality following amputation, the authors reviewed the records of 504 patients from three Toronto teaching hospitals who had one or both limbs removed at or above the below-knee level. It appears that (a) previous vascular surgery or sympathectomy, or both, actually increases the number of patients in whom a below-knee amputation is successful, (b) the number of revision procedures necessary is increased after failed vascular surgery or sympathectomy, or both and (c) revision procedures following amputation do not affect the mortality from lower limb amputation.