"Angioplasty-First" Approach for Limb Salvage in Asian Patients with Critical Limb Ischemia: Outcomes from 3,303

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

Published on: September 22, 2020

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Wen Wen Ni1, Sum Leong1, Farah Irani1

  • 1Department of Vascular and Interventional Radiology, Singapore General Hospital, Outram Road, Singapore.

Journal of Vascular and Interventional Radiology : JVIR
|November 3, 2020
PubMed

Insights

Percutaneous transluminal angioplasty (PTA) is a safe and effective first-line treatment for critical limb ischemia (CLI). This study found PTA offers good limb salvage and survival rates, with predictors like diabetes and end-stage renal disease impacting outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Critical limb ischemia (CLI) poses a significant threat to limb salvage and patient survival.
  • Effective revascularization strategies are crucial for managing CLI.
  • Conventional percutaneous transluminal angioplasty (PTA) is a common first-line treatment option.

Purpose of the Study:

  • To review the outcomes of patients with CLI who underwent conventional PTA as a primary revascularization strategy.
  • To identify predictors of limb salvage and mortality in this patient cohort.

Main Methods:

  • Retrospective review of 3,303 PTA procedures in 1,968 patients with CLI.
  • Kaplan-Meier analysis for limb salvage rates.
  • Univariate and multivariate Cox regression to identify predictors of major amputation and mortality.

Main Results:

  • Limb salvage rates at 1, 3, 5, and 10 years were 75%, 73%, 72%, and 62%, respectively.
  • Overall survival rates at 1, 3, 5, and 10 years were 79%, 64%, 56%, and 34%, respectively.
  • Predictors for major amputation included diabetes mellitus, end-stage renal disease, and repeat interventions. Significant mortality predictors included age, male sex, and end-stage renal disease.

Conclusions:

  • Conventional PTA is a safe and effective first-line revascularization treatment for patients with CLI.
  • The study identified key clinical predictors influencing limb salvage and survival outcomes.
  • Further research is recommended to validate the developed outcome predictive model.
Abstract

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