Related Experiment Video

Updated: Jul 19, 2025

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

3.5K

Chronic Limb-Threatening Ischemia in Patients with Type 2 Diabetes: Revascularization Index as a Predictor for

Nawaf J Shatnawi1, Nabil A Al-Zoubi1, Lujain A Al-Bakkar1

  • 1Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan.

Vascular Health and Risk Management
|August 7, 2023
PubMed

Insights

A new Revascularization Index (RI) effectively predicts outcomes for patients with type 2 diabetes and chronic limb-threatening ischemia undergoing endovascular intervention. Lower RI scores indicate a higher risk of major amputation and need for secondary revascularization.

Area of Science:

  • Vascular Surgery
  • Diabetology
  • Interventional Radiology

Background:

  • Chronic limb-threatening ischemia (CLTI) in diabetic patients carries a high risk of adverse outcomes.
  • Complexities in diabetic CLTI management include comorbidities, varied foot presentations, and diffuse atherosclerotic lesions.
  • Existing scoring systems and revascularization strategies aim to optimize outcomes.

Purpose of the Study:

  • Introduce a novel Revascularization Index (RI).
  • Evaluate the predictive capability of the RI for outcomes following primary endovascular intervention in type 2 diabetes patients with CLTI.

Main Methods:

  • Retrospective review of electronic medical records for 187 patients with type 2 diabetes and CLTI.
  • Patients underwent primary endovascular interventions between January 2014 and August 2019.
  • Analysis of the RI's predictive value for secondary revascularization, major amputation, and mortality.

Main Results:

  • The study included 187 patients, with a 19.3% major lower limb amputation rate.
  • The RI demonstrated excellent prediction for secondary revascularization (AUC=0.80) and good prediction for major amputation (AUC=0.76).
  • An RI <1.21 significantly correlated with increased major lower limb amputation risk (HR=5.8), and RI <1.3 predicted higher secondary revascularization needs.

Conclusions:

  • The Revascularization Index (RI) can predict major adverse lower limb events (MALE) in diabetic CLTI patients.
  • The RI may serve as a valuable tool to guide the extent of endovascular interventions.
  • This index is particularly relevant for managing diabetic CLTI with multi-level outflow atherosclerotic disease.
Abstract

Keywords:
amputationangioplastychronic limb-threatening ischemiadiabetes mellitusrevascularization index

More Related Videos

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

8.8K
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

3.5K

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...
17
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11
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...
12
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
12