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Global Limb Anatomic Staging System Score correlates with the clinical outcomes in chronic limb threatening ischemia

Hongli Liao1, Chengqi Xu2, Pengyun Wang3

  • 1Department of Radiology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

International Angiology : a Journal of the International Union of Angiology
|June 16, 2022
PubMed

Insights

The Global Limb Anatomic Staging System (GLASS) effectively predicts outcomes for chronic limb-threatening ischemia (CLTI). Higher GLASS stages correlate with increased treatment intensity and reduced amputation-free survival at one year.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Imaging

Background:

  • Chronic limb-threatening ischemia (CLTI) presents a significant global health challenge.
  • The Global Limb Anatomic Staging System (GLASS) was developed to standardize the assessment of limb threat complexity.

Purpose of the Study:

  • To evaluate the correlation between GLASS stages and treatment intensity for CLTI.
  • To assess the predictive value of GLASS for clinical outcomes, including amputation-free survival (AFS), reintervention, and mortality.

Main Methods:

  • Retrospective classification of computed tomography angiography images into GLASS stages (I, II, III).
  • Comparison of comorbidities, treatments, and outcomes (AFS, reintervention, mortality) across GLASS stages.
  • Kaplan-Meier analysis and multivariate analysis to identify predictors of outcomes.

Main Results:

  • 285 limbs were stratified: 19% stage I, 45% stage II, 36% stage III.
  • Increased GLASS stage correlated with higher rates of endovascular revascularization and minor amputation.
  • Increasing GLASS stage was associated with reduced 1-year AFS (Stage I: 96.1%, Stage II: 94.1%, Stage III: 83.9%).
  • Infrapopliteal GLASS grades 3-4 independently predicted reduced AFS.

Conclusions:

  • GLASS stage is a reliable indicator of treatment intensity and 1-year clinical outcomes in CLTI.
  • Higher infrapopliteal GLASS grades (3-4) are independent predictors of diminished amputation-free survival.
Abstract

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