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07:25
Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
Persistent Poor Survival Following Lower-Limb Amputation for Peripheral Artery Disease: A National Study
Judith A H M Peeters1, Joost R van der Vorst1, Jan van Schaik1
1Department of Vascular Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
Annals of Vascular Surgery
|August 7, 2026
Summary
Lower-limb amputation incidence decreased, and short-term survival improved for peripheral artery disease (PAD) patients. However, long-term survival remains poor, especially for younger diabetic patients, highlighting the need for better prevention and treatment.
Area of Science:
- Vascular Surgery
- Public Health
- Epidemiology
Background:
- Lower-limb amputation is a severe complication of peripheral artery disease (PAD).
- Factors like improved cardiovascular care, increased diabetes rates, and an aging population may impact amputation trends.
- Understanding temporal changes in amputation incidence and outcomes is crucial for public health initiatives.
Purpose of the Study:
- To evaluate changes in the incidence of PAD-related lower-limb amputations.
- To assess trends in short- and long-term survival rates after amputation.
- To compare outcomes between two distinct periods: 1995-1999 and 2014-2018.
Main Methods:
- Nationwide observational cohort study using linked registry data.
- Inclusion of patients over 45 years old undergoing PAD-related amputations.
- Comparison of patient demographics, amputation incidence, survival rates, and causes of death between the two study periods.
Main Results:
- Overall amputation incidence decreased by 16.3% over time.
- Median patient age, proportion of major amputations, and hospital stay decreased, while male proportion and comorbidity burden (including diabetes) increased.
- Six-month survival improved significantly (75.6% to 83.4%), but long-term survival remained poor (5-year relative survival 0.51-0.80), with high excess mortality, particularly in younger and diabetic patients.
Conclusions:
- Short-term survival post-amputation has improved between 1995-1999 and 2014-2018.
- Long-term outcomes after amputation are still poor, especially for younger patients with diabetes and those undergoing major amputations.
- PAD-related amputations identify a high-risk, multimorbid population requiring enhanced preventive strategies and advanced treatment approaches.
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