HIV-occlusive vascular disease

Show simple item record Van Marle, J. Mistry, P.P. Botes, K. 2009-09-23T10:00:27Z 2009-09-23T10:00:27Z 2009-05
dc.description.abstract OBJECTIVES: To evaluate peripheral arterial occlusive disease in HIV-infected patients regarding clinical presentation and outcome of surgical intervention. DESIGN: Prospective clinical survey. PATIENTS AND METHODS: Routine voluntary testing for HIV / AIDS was performed in all patients presenting to our vascular unit. HIV+ patients were enrolled in a registry and followed up prospectively. RESULTS: We identified 154 HIV+ patients, of whom 91 (59%) presented with occlusive disease. There were 71 males and 20 females with a mean age of 44.2 years. The usual risk factors for atherosclerosis were present, but the incidence was less than reported in the classic atherosclerosis population. More than 90% of the patients presented with advanced stage vascular disease (Fontaine III/IV), which explains the high rate (31.9%) of primary amputation. Eighty-seven patients presented with lower-limb ischaemia, 2 patients with upper-limb ischaemia and 2 patients with symptomatic carotid artery stenosis. Seventy-eight procedures were performed on 72 patients, with a perioperative mortality of 6.95%. The limb salvage rate for femoro-popliteal bypassprocedures was poor (36.1%), resulting in a high incidence of secondary amputations and prolonged hospital stay. Long-term mortality for the operated patients was 20% over a mean follow-up period of 15.4 months. Hypo-albuminaemia was found to be an important predictor of outcome. CONCLUSION: Patients presenting with HIV-associated peripheral arterial disease should be carefully selected for intervention, taking into consideration nutritional and immune status, stage of the vascular disease and selecting the appropriate procedure. en_US
dc.identifier.citation Van Marle, J, Mistry, PP & Botes, K 2009, 'HIV-occlusive vascular disease', South African Journal of Surgery, vol. 47, no. 2, pp. 36-42. [] en_US
dc.identifier.issn 0038-2361
dc.language.iso en en_US
dc.publisher Health and Medical Publishing Group en_US
dc.rights Health and Medical Publishing Group en_US
dc.subject HIV-occlusive en
dc.subject Vascular disease en
dc.subject Peripheral arterial occlusive disease en
dc.subject Clinical survey en
dc.subject.lcsh HIV-positive persons -- Research en
dc.subject.lcsh Blood-vessels -- Diseases -- Research en
dc.subject.lcsh Peripheral vascular diseases -- Research en
dc.subject.lcsh Operations, Surgical en
dc.title HIV-occlusive vascular disease en_US
dc.type Article en_US

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