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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

Predictors of adverse clinical outcomes after successful infrapopliteal intervention

Osami Kawarada1, Masahiko Fujihara, Akihiro Higashimori

  • 1Department of Cardiovascular Medicine, Nishinokyo Hospital, Nara-City, Japan. kawarada90@hotmail.com

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 21, 2012
PubMed

Insights

Successful infrapopliteal intervention for critical limb ischemia can lead to delayed wound healing and amputation. Infectious wounds, diabetes, and end-stage renal disease (ESRD) are key predictors of adverse outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Critical Limb Ischemia Management

Background:

  • Adverse clinical outcomes after successful infrapopliteal intervention are often underestimated.
  • Critical limb ischemia (CLI) with tissue loss poses significant challenges in limb salvage and patient survival.

Purpose of the Study:

  • To identify clinical and angiographical predictors of delayed wound healing, major amputation, and death following successful infrapopliteal intervention in CLI patients.
  • To improve risk stratification and patient management strategies for CLI.

Main Methods:

  • A retrospective analysis of 106 limbs in 85 patients undergoing stent-assisted infrapopliteal angioplasty for CLI.
  • Successful intervention was defined as achieving at least one straight-line flow to the foot.
  • Multivariate Cox analysis was used to identify independent predictors of outcomes.

Main Results:

  • At 5 years, repeat intervention-free rates were 36.1%, amputation-free survival was 39.8%, and limb salvage was 86.3%.
  • Infectious wounds independently predicted major amputation.
  • Diabetes mellitus, infectious wounds, and pedal arch classification predicted wound healing. End-stage renal disease (ESRD) on hemodialysis predicted mortality.

Conclusions:

  • Infectious wounds, diabetes mellitus, ESRD on hemodialysis, and pedal arch classification are significant predictors of adverse outcomes after successful infrapopliteal intervention.
  • These factors should be considered in the management of CLI patients to optimize treatment and improve prognosis.
  • Further research into targeted interventions for these high-risk patient groups is warranted.
Abstract

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