Related Experiment Video

Updated: Oct 21, 2025

Compensatory Limb Use and Behavioral Assessment of Motor Skill Learning Following Sensorimotor Cortex Injury in a Mouse Model of Ischemic Stroke
08:01

Compensatory Limb Use and Behavioral Assessment of Motor Skill Learning Following Sensorimotor Cortex Injury in a Mouse Model of Ischemic Stroke

Published on: July 10, 2014

11.7K

Features of asymptomatic contralateral limb in patients with chronic limb-threatening ischemia

Mitsuyoshi Takahara1, Osamu Iida2, Yoshimitsu Soga3

  • 1Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan; Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

Journal of Cardiology
|September 2, 2021
PubMed

Insights

Many patients with chronic limb-threatening ischemia (CLTI) have severe ischemia in their asymptomatic limb, increasing risks for major adverse limb events (MALE) and mortality. Early identification of risk factors is crucial for better patient outcomes.

Area of Science:

  • Vascular Surgery
  • Ischemic Limb Disease
  • Patient Prognosis

Background:

  • Chronic limb-threatening ischemia (CLTI) poses significant risks to patients.
  • Understanding the clinical features and prognosis of asymptomatic contralateral limbs is vital for comprehensive patient care.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of asymptomatic contralateral limbs in patients undergoing revascularization for CLTI.
  • To identify risk factors associated with severe ischemia in these limbs.

Main Methods:

  • Analysis of a prospective, multicenter registry of 520 CLTI patients in Japan.
  • Assessment of asymptomatic contralateral limbs using the Wound, Ischemia, and foot Infection (WIfI) classification system (Ischemia grade I-2/3).
  • Multivariate analysis to identify independent risk factors for severe ischemia and evaluation of 3-year cumulative incidence of major adverse limb events (MALE) and mortality.

Main Results:

  • 65.0% of CLTI patients had asymptomatic contralateral limbs, with 55.0% exhibiting WIfI I-2/3 (severe ischemia).
  • Independent risk factors for WIfI I-2/3 included older age (≥65 years), dialysis-dependent renal failure, WIfI I-3 in the index limb, and loss of pressure sensation in the contralateral limb.
  • The 3-year cumulative incidence rates were 19.3% for MALE and 46.9% for all-cause mortality in asymptomatic contralateral limbs, with a composite rate of 58.8% for mortality and MALE.

Conclusions:

  • Two-thirds of CLTI patients present with an asymptomatic contralateral limb, half of which show severe ischemia.
  • Severe ischemia in asymptomatic limbs is linked to older age, renal failure, index limb severity, and sensory loss.
  • Asymptomatic limbs with WIfI I-2/3 are prone to MALE and mortality, underscoring the need for vigilant monitoring and management.
Abstract

Keywords:
Asymptomatic contralateral limbChronic limb-threatening ischemiaMajor adverse limb eventMortalitySevere ischemia

More Related Videos

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model08:16

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

Published on: March 16, 2022

3.7K
Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia07:48

Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia

Published on: June 8, 2019

8.9K

Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
73
Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
594
Arteries of Lower Limbs01:20

Arteries of Lower Limbs

The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular...
2.9K
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
66
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
88
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
77