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Journals / International Anatolia Academic Online Journal Health Sciences / 2026 / Cilt: 12 Sayı: 2

Prevention of Ischemia–Reperfusion Injury After Emergency Revascularization for Acute Limb Ischemia: A Singlecenter Retrospective Cohort Study Evaluating Perioperative Protective Strategies and Clinical Outcomes

Akut Ekstremite İskemisi İçin Acil Revaskülarizasyon Sonrası İskemi-Reperfüzyon Hasarının Önlenmesi: Perioperatif Koruyucu Stratejileri ve Klinik Sonuçları Değerlendiren Tek Merkezli Retrospektif Kohort Çalışması

Orhan Rodoplu(BAHCESEHIR CYPRUS UNIVERSITY)
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Publication Date
2026-10-20
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Pharmacological and surgical prevention strategies have a synergistic effect and significantly decrease reperfusion injury and improve limb salvage following emergency revascularization procedures for ALI.

📌 3 Key Takeaways

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Objective & Hypothesis:Background and Objective : Acute limb ischemia (ALI) is considered a vascular emergency and needs urgent revascularization, however, reperfusion, paradoxically, causes cell damage termed ischemia–reperfusion injury (IRI).
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Key Findings & Data:Methods: Data from four tertiary vascular surgery centers were collected in a singel center, retrospective cohort study of 348 patients who underwent emergency revascularization for ALI between January 2021 and December 2025.
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Conclusion & Impact:Conclusion: Pharmacological and surgical prevention strategies have a synergistic effect and significantly decrease reperfusion injury and improve limb salvage following emergency revascularization procedures for ALI.
🔬Design:Modeling & Simulation
📍Scope:2021 Verileri
⚙️Variables:Akut uzuv iskemisi · iskemi-reperfüzyon hasarı · acil revaskülarizasyon

Abstract

Background and Objective : Acute limb ischemia (ALI) is considered a vascular emergency and needs urgent revascularization, however, reperfusion, paradoxically, causes cell damage termed ischemia–reperfusion injury (IRI). There is no standard protocol for the prevention of perioperative complications.The author assessed the relationship between perioperative protective measures and reperfusion injury after emergency surgical revascularization for ALI. Methods: Data from four tertiary vascular surgery centers were collected in a singel center, retrospective cohort study of 348 patients who underwent emergency revascularization for ALI between January 2021 and December 2025. Patients were divided into four groups: standard management (Group A: n = 95), pharmacological prevention (Group B: n = 88), surgical prevention (Group C: n = 82), combined prevention (Group D: n = 83). The primary outcomes were reperfusion injury, limb salvage, major amputation, and 30-day mortality. Independent predictors were identified with multivariable logistic regression. Results: The combined prevention (Group D) had the least reperfusion injury (12.0%) compared to the standard care (38.9%) group (P 6 hours (OR = 3.41, p < 0.001) and Rutherford grade III (OR = 2.95, p < 0.001) were independent risk factors, while combined prevention was strongly protective (OR = 0.21, p < 0.001). The ROC AUC of the combined biomarker model for predicting IRI was 0.89. Conclusion: Pharmacological and surgical prevention strategies have a synergistic effect and significantly decrease reperfusion injury and improve limb salvage following emergency revascularization procedures for ALI.

Özet

Giriş ve Amaç: Akut ekstremite iskemisi (ABİ), vasküler bir acil durum olarak kabul edilir ve acil revaskülarizasyon gerektirir; ancak, paradoksal olarak, reperfüzyon iskemi-reperfüzyon hasarı (İSY) olarak adlandırılan hücre hasarına neden olur. Ameliyat öncesi ve sonrası komplikasyonların önlenmesi için standart bir protokol bulunmamaktadır. Yazar, Aİİ için acil cerrahi revaskülarizasyon sonrası ameliyat öncesi ve sonrası koruyucu önlemler ile reperfüzyon hasarı arasındaki ilişkiyi değerlendirmiştir. Yöntem: Ocak 2021 ile Aralık 2025 tarihleri ​​arasında Aİİ için acil revaskülarizasyon geçiren 348 hastanın verileri, dört üçüncü basamak vasküler cerrahi merkezinden tek merkezli, retrospektif kohort çalışmasında toplanmıştır. Hastalar dört gruba ayrılmıştır: standart yönetim (Grup A: n = 95), farmakolojik önleme (Grup B: n = 88), cerrahi önleme (Grup C: n = 82), kombine önleme (Grup D: n = 83). Birincil sonuçlar reperfüzyon hasarı, uzuv kurtarma, büyük amputasyon ve 30 günlük mortalite idi. Bağımsız prediktörler çok değişkenli lojistik regresyon ile belirlendi. Sonuçlar: Kombine önleme (Grup D), standart bakım grubuna (%38,9) kıyasla en düşük reperfüzyon hasarına (%12,0) sahipti (P ​​< 0,001). Büyük amputasyon sayısı %12,6'dan (Grup A) %3,6'ya (Grup D) düştü. 30 günlük mortalite oranı %9,5'ten %2,4'e düştü. 6 saatten uzun süren iskemi süresi (OR = 3,41, p < 0,001) ve Rutherford III derecesi (OR = 2,95, p < 0,001) bağımsız risk faktörleri iken, kombine önleme güçlü bir koruyucu etkiye sahipti (OR = 0,21, p < 0,001). İskemik reperfüzyon hasarını tahmin etmek için kullanılan kombine biyobelirteç modelinin ROC AUC değeri 0,89'dur. Sonuç: Farmakolojik ve cerrahi önleme stratejileri sinerjik bir etkiye sahiptir ve akut uzuv hasarı (ALI) için acil revaskülarizasyon prosedürlerini takiben reperfüzyon hasarını önemli ölçüde azaltır ve uzuv kurtarma oranını artırır.

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Cite This Article

Rodoplu, O. (2026). Prevention of Ischemia–Reperfusion Injury After Emergency Revascularization for Acute Limb Ischemia: A Singlecenter Retrospective Cohort Study Evaluating Perioperative Protective Strategies and Clinical Outcomes. International Anatolia Academic Online Journal Health Sciences, Cilt: 12 Sayı: 2. https://ajindex.com/articles/1492839

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