Related Experiment Video
Updated: Nov 14, 2025
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Zinc Deficiency and Clinical Outcome After Infrainguinal Bypass Grafting for Critical Limb Ischemia
Akio Koyama1,2, Akio Kodama1, Takuya Tsuruoka1
1Division of Vascular Surgery, Departments of Surgery, Nagoya University Graduate School of Medicine Nagoya Japan.
Insights
Zinc deficiency is linked to worse outcomes in critical limb ischemia patients undergoing bypass surgery. Addressing zinc levels may improve limb salvage and healing rates.
Area of Science:
- Vascular Surgery
- Nutritional Biochemistry
Background:
- Critical limb ischemia (CLI) poses significant challenges to limb salvage.
- Nutritional status, specifically zinc levels, may impact outcomes in CLI patients.
Purpose of the Study:
- To investigate the association between zinc deficiency and clinical outcomes in patients with CLI undergoing infrainguinal bypass grafting (IBG).
- To determine if zinc deficiency is an independent predictor of poor outcomes after IBG.
Main Methods:
- Retrospective review of 45 limbs from 44 CLI patients undergoing de novo IBG.
- Patients were stratified into zinc deficiency (Zn <60 µg/dL) and zinc sufficiency (Zn ≥60 µg/dL) groups.
- Comparison of graft patency, limb salvage (LS), amputation-free survival (AFS), and wound healing between groups.
Main Results:
- The zinc deficiency group had significantly lower rates of graft patency, LS, AFS, and complete wound healing.
- Zinc deficiency was identified as a negative predictor of LS.
- Hemodialysis and age >75 years were predictors of zinc deficiency.
Conclusions:
- Zinc deficiency is associated with poor clinical outcomes in CLI patients undergoing IBG.
- Zinc supplementation could potentially enhance clinical outcomes in this patient population.
Abstract:
The aim of this study was to identify a relationship between zinc (Zn) deficiency and clinical outcome in patients with critical limb ischemia (CLI). Forty-five limbs from 44 patients with CLI who underwent de novo infrainguinal bypass grafting (IBG) were retrospectively reviewed. The patients were divided into a Zn deficiency group (ZD group: Zn <60 µg/dL) and a Zn sufficiency group (ZS group: Zn ≥60 µg/dL). Graft patency, limb salvage (LS), amputation-free survival (AFS), and wound healing were compared between the groups. LS and AFS were examined to identify whether Zn deficiency was an independent predictor. The preoperative factors potentially predictive of Zn deficiency were also analyzed. Twenty-four limbs were categorized into the ZD group. Patients in the ZD group were more likely to have undergone hemodialysis (HD) and have lower serum albumin. The surgical procedures were not significantly different between the groups. Patency, LS, AFS, and complete wound healing rates were significantly lower in the ZD group. Zn deficiency was a negative predictor of LS. Age >75 years and HD were identified as predictors of Zn deficiency. Zn deficiency was associated with poor clinical outcome. Zn supplementation may improve clinical outcomes during IBG for CLI.
