Related Experiment Video
Updated: May 10, 2025
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Acute Limb Ischemia After Percutaneous Coronary Intervention for Stable Coronary Artery Disease
Monil Majmundar1, Wan-Chi Chan1, Vivek Bhat2
1Department of Cardiovascular Medicine University of Kansas Medical Center Kansas City KS USA.
Insights
Acute limb ischemia (ALI) is a rare but serious complication following percutaneous coronary interventions (PCI) in stable coronary artery disease patients. Peripheral artery disease significantly increases ALI risk, leading to higher mortality and amputation rates.
Area of Science:
- Cardiovascular Interventions
- Vascular Surgery
- Interventional Cardiology
Background:
- Acute limb ischemia (ALI) following percutaneous coronary interventions (PCI) for stable coronary artery disease is severe but understudied.
- Limited data exists on ALI incidence, predictors, and outcomes in this patient population.
Purpose of the Study:
- To determine the incidence and predictors of ALI after PCI in patients with stable coronary artery disease.
- To evaluate the outcomes associated with ALI in this cohort.
Main Methods:
- Analysis of the Nationwide Readmissions Database (2016-2020) for patients undergoing PCI for stable coronary artery disease.
- Identification of ALI cases using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes.
- Statistical analysis to identify ALI predictors and associated risks.
Main Results:
- A total of 629,656 patients underwent PCI; 3,456 (0.55%) developed ALI.
- Peripheral artery disease was the strongest predictor of post-PCI ALI (OR, 53.03).
- ALI patients faced increased in-hospital mortality (1.6x) and major amputation risk (4.7x).
- Embolectomy was associated with higher mortality, while thrombolysis correlated with greater amputation rates.
Conclusions:
- ALI is an infrequent but high-risk complication of PCI in stable coronary artery disease.
- Peripheral artery disease is a critical predictor for developing ALI post-PCI.
- ALI significantly elevates the risk of mortality and limb amputation.
Introduction:
Despite its severity, there is limited information on the incidence, predictors, and outcomes of acute limb ischemia (ALI) after percutaneous coronary interventions (PCIs) in stable coronary artery disease.
Methods And Results:
We included all patients undergoing PCI for stable coronary artery disease in the Nationwide Readmissions Database from 2016 to 2020, identifying them using appropriate International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), codes. Our primary outcomes were the incidence and predictors of ALI. A total of 629 656 patients underwent PCI for stable coronary artery disease. Of this sample, 3456 (0.55%) had ALI. Peripheral artery disease was the strongest predictor of post-PCI ALI (odds ratio, 53.03 [95% CI, 43.76-64.28], P<0.001). Patients with ALI had a 1.6 times greater risk of in-hospital mortality and a 4.7 times greater risk of in-hospital major amputation. Forty point nine percent of patients with ALI underwent embolectomy, while 11.6% received thrombolysis. Outcomes were similar between ALI of the upper and lower extremity. Patients undergoing embolectomy had greater in-hospital mortality, while the thrombolysis group had greater in-hospital major amputation.
Conclusion:
ALI is an uncommon complication of PCI but is associated with a high risk of mortality and amputation. Peripheral artery disease is the strongest predictor of post-PCI ALI.
More Related Videos
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:27Assessment of the Cardiovascular System III: Palpation
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...