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Updated: Jul 11, 2025

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
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Outcomes and use of healthcare resources after an intervention for chronic limb-threatening ischaemia

Athanasios Saratzis1, Liam Musto1, Santosh Kumar2

  • 1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

BJS Open
|November 6, 2023
PubMed

Insights

For chronic limb-threatening ischemia, revascularization has similar healthcare costs and appointments compared to primary amputation. Patients undergoing amputation experienced higher cardiovascular events and mortality within one year.

Area of Science:

  • Vascular Surgery
  • Health Economics
  • Patient Outcomes

Background:

  • Chronic limb-threatening ischemia (CLTI) poses a significant challenge, with unclear outcomes for patients undergoing revascularization versus primary amputation.
  • Assessing postoperative results and healthcare resource utilization is crucial for informed clinical decision-making.

Purpose of the Study:

  • To compare 1-year postoperative outcomes and healthcare costs between revascularization and primary amputation for CLTI.
  • To analyze healthcare resource use across primary, community, and secondary care settings.

Main Methods:

  • Utilized the UK Kent Integrated Dataset, linking 1.6 million patient records across care settings.
  • Identified patients with new CLTI diagnoses undergoing revascularization or major amputation between January 2016 and January 2019.
  • Analyzed postoperative events and healthcare resource use for 1 year post-procedure.

Main Results:

  • Of 579 patients who underwent intervention, 296 had angioplasty, 75 bypass surgery, and 141 a primary amputation.
  • Readmissions were similar across procedures; bypass surgery led to more appointments (median 4 vs 2).
  • Primary amputation was linked to higher cardiovascular events and 1-year mortality, with no significant cost differences between procedures.

Conclusions:

  • Revascularization for CLTI is not associated with increased healthcare appointments or costs compared to primary amputation over 1 year.
  • Patients undergoing primary amputation face higher risks of cardiovascular events and mortality.
Abstract

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