Related Experiment Video
Updated: May 7, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Correlation of cerebral small vessel disease burden with outcome after lower extremity amputation
Marcin Kolasa1, Otso Arponen2, Ilkka Kaartinen3
1Department of Radiology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.
Insights
Cerebral small vessel disease (CSVD) changes on head CT scans predict survival after lower extremity amputation (LEA). White matter lesions and infarcts are linked to poorer overall survival and amputation-free survival.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Cerebral small vessel disease (CSVD) is a common finding on neuroimaging.
- The prognostic value of CSVD in patients undergoing lower extremity amputation (LEA) is not well understood.
- Head CT scans, often obtained for other clinical reasons, may provide incidental findings related to CSVD.
Purpose of the Study:
- To determine if CSVD markers on head CT scans predict overall survival (OS), leg salvage (LS), and amputation-free survival (AFS) in patients with LEA.
- To investigate the association between white matter lesions (WMLs) and infarcts with patient outcomes after LEA.
Main Methods:
- Retrospective cohort study of 240 patients who underwent LEA between 2007 and 2020.
- Head CT scans obtained within one year prior to LEA were reviewed.
- A neuroradiologist graded WMLs and identified infarcts, with subsequent analysis of their impact on OS, LS, and AFS.
Main Results:
- 67.5% of patients had WMLs, and 38.1% had infarcts.
- Both mild/moderate and severe WMLs, as well as infarcts, were associated with significantly inferior OS.
- Mild/moderate and severe WMLs were also associated with inferior AFS after minor LEA.
Conclusions:
- CSVD findings, specifically WMLs and infarcts on head CT, are significant predictors of impaired OS following LEA.
- These CSVD markers also predict AFS after minor LEA.
- Assessing CSVD on routine head CT scans can offer valuable prognostic information for clinicians managing patients with LEA.
Aims:
This study assessed whether changes associated with cerebral small vessel disease (CSVD) evaluated from head computed tomography (CT) images captured for non-related clinical purposes predict overall survival (OS), leg salvage (LS), and amputation-free survival (AFS) after lower extremity amputation (LEA).
Methods:
We retrospectively included a cohort of 240 patients who had undergone a lower extremity amputation in Tampere University Hospital between the years 2007 and 2020 and had a head CT scan (within one year before amputation). A neuroradiologist graded the white matter lesions (WMLs) and reported infarcts, and the latter's effects on OS, LS, and AFS were evaluated.
Results:
Altogether, 162 (67.5 %) and 91 (38.1 %) patients had WMLs and infarcts, respectively. Mild/moderate (HR 1.985, CI 95 % 1.317-2.992) and severe (HR 2.259, CI 95 % 1.501-3.399) WMLs and infarcts (HR 1.413, CI 95 % 1.029-1.940) were associated with inferior OS. After a minor amputation, mild/moderate (HR 2.012, CI 95 % 1.054-3.843) and severe (HR 3.879, CI 95 % 2.096-7.180) WMLs were similarly associated with inferior AFS.
Conclusions:
Overall, WML and infarcts detected on head CT scans were associated with impaired OS after LEA and AFS after minor LEA. Evaluation of CSVD could provide useful prognostic information for clinicians.
More Related Videos
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
06:37Electroencephalography Network Indices as Biomarkers of Upper Limb Impairment in Chronic Stroke
Published on: July 14, 2023
