Sarcopenia and outcomes after revascularization for peripheral arterial disease: a scoping review

Sarcopenia, a degenerative skeletal muscle disease associated with aging and chronic diseases, is a recognized risk factor for poor postoperative outcomes in various surgical fields. However, in patients with peripheral artery disease (PAD) undergoing revascularization, systematic evidence on its epidemiology, assessment practices, and prognostic impact is lacking. This scoping review aims to synthesize available evidence to clarify the prevalence, diagnostic methods, and association between sarcopenia and adverse postoperative outcomes in patients with PAD, thereby informing perioperative risk stratification and targeted interventions.

This study was conducted following the Arksey & O'Malley scoping review framework and the Joanna Briggs Institute (JBI) revised scoping review methodology. Relevant studies were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang Data, and VIP Chinese Science and Technology Journal Database from inception to June 30, 2025. Eligible studies were published in Chinese or English and focused on the impact of sarcopenia on the prognosis of patients with PAD. The extracted data were collated, categorized, and summarized.

Twelve studies were included. The prevalence of sarcopenia in patients with PAD ranged from 9.01% to 66.67%. Most existing studies diagnosed sarcopenia solely based on imaging-derived muscle parameters without comprehensive assessment of muscle strength and physical function. Despite these methodological limitations, imaging-evident muscle loss was correlated with elevated postoperative mortality, increased risk of cardiovascular events, and poor limb prognosis in patients with PAD.

Sarcopenia is prevalent among patients with PAD and serves as a potential risk factor for adverse postoperative outcomes. Inconsistent diagnostic criteria and substantial methodological heterogeneity across current studies restrict the generalizability of available evidence. Future efforts are required to establish a standardized, multidimensional assessment system for sarcopenia, and high-quality prospective studies are needed to clarify its perioperative prognostic value.