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Resultados Clínicos Asociados con Sistemas de Puntuación Angiográfica de Extremidades Inferiores: Una Revisión

Thomas J Lyons¹, Nanthesh Kiruparan², Muhammed Ahmed³

¹Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK.

Annals of vascular surgery

|January 16, 2026

Resumen

Los sistemas de puntuación angiográfica como GLASS, TASC y Bollinger tienen evidencia limitada para predecir los resultados en la isquemia crónica amenazante de las extremidades. La puntuación GLASS puede afectar los resultados de la intervención endovascular, pero su papel en la cirugía de bypass es incierto.

Área de la Ciencia:

Cirugía Vascular
Radiología Intervencionista
Investigación de Resultados Clínicos

Sus antecedentes:

La isquemia crónica amenazante de las extremidades (CLTI) conlleva altas tasas de mortalidad y pérdida de extremidades.
Las guías actuales recomiendan sistemas de puntuación angiográfica (p. ej., GLASS, TASC, Bollinger) para evaluar la gravedad de la CLTI.
La evidencia que respalda el valor predictivo de estos sistemas de puntuación para los resultados clínicos es limitada.

Objetivo del estudio:

Revisar sistemáticamente la evidencia sobre la capacidad de los sistemas de puntuación angiográfica (GLASS, TASC, Bollinger) para predecir los resultados clínicos en CLTI.
Evaluar el rendimiento pronóstico de estos sistemas de puntuación en diferentes cohortes de tratamiento.

Principales métodos:

Revisión sistemática de Ovid MEDLINE, Embase y Cochrane Library (1977-2025).
Los estudios incluidos evaluaron la angiografía infrainguinal utilizando GLASS, TASC o Bollinger y reportaron resultados clínicos.
Se realizó una síntesis narrativa debido a la heterogeneidad de los puntos finales.

Principales resultados:

Ocho estudios fueron incluidos (cinco GLASS, dos TASC, uno Bollinger).
La puntuación GLASS mostró asociaciones mixtas con la supervivencia general, la supervivencia libre de amputación y el salvamento de extremidades en cohortes endovasculares; no se encontró correlación en cohortes de bypass.
Las puntuaciones TASC y Bollinger no demostraron una asociación consistente con los resultados clínicos.

Conclusiones:

La evidencia sobre los sistemas de puntuación angiográfica que predicen los resultados de CLTI es escasa y de baja calidad.
La puntuación GLASS puede tener valor pronóstico en intervenciones endovasculares, pero su utilidad en bypass no está clara.
La investigación futura debe incluir la enfermedad inframaleolar, la circulación colateral y la validación prospectiva.

Palabras clave:

Angiograma Bollinger Isquemia Crónica Amenazante de las Extremidades GLASS Enfermedad Arterial Periférica TASC

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