Abstract 18886: Predictors for Long-term Clinical Outcomes After Endovascular Treatment in Patients With Critical Limb Ischemia

• Published in: Circulation (New York, N.Y.) N.Y.), 2015-11, Vol.132 (Suppl_3 Suppl 3), p.A18886-A18886
• Main Authors: Jujo, Kentaro, Nakao, Masashi, Yamaguchi, Junichi, Otsuki, Hisao, Shimazaki, Kensuke, Kamishima, Kazuho, Arashi, Hiroyuki, Hagiwara, Nobuhisa
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.132.suppl_3.18886

BackgroundsCritical limb ischemia (CLI) is a severe clinical presentation of patients with peripheral artery disease, and their limb salvage and survival rates are extremely poor. However, there is still only limited evidence from observational studies for contemporary outcomes in CLI patients who underwent endovascular treatment (EVT) including both above and below the knee lesion. Therefore, this study aimed to evaluate the prognostic and predictive factors for patients with CLI who underwent EVT.MethodsCumulative total number of 192 patients with CLI who underwent EVT between March 2009 and April 2014 was prospectively enrolled. After the exclusion of patients who were lost to follow-up within 6 months, 175 patients were retrospectively analyzed for clinical and angiographic parameters. The primary endpoints of this study were all-cause death and major amputation above the ankle joint.ResultsThe study population was typically elderly (average age68 year-old) and 76% male with a normal body mass index (BMI23 kg/m2) and diverse comorbidities, including 34% diabetes and 72% maintenance hemodialysis. Target lesions consisted of 23% aortoiliac, 56% femoropopliteal and 67% below-the-knee arteries, including 37% isolated below-the-knee lesion. Median follow-up period was 23.9 months. Survival rate and major amputation free rate at 1-year were 87% and 95%, respectively (Figure). Multivariate analysis elucidated that low BMI and cerebrovascular disease were independent predictors for all-cause mortality (Table 1). Interestingly, infection was the leading cause of death (23 patients (46%), and main focus of infection was lower extremities (15 patients (30%)). As for major limb amputation, current smoking was the only independent predictor (Table 2).ConclusionThis study demonstrates that low BMI and cerebrovascular disease predict all-cause mortality, and current smoking does major amputation after EVT in patients with CLI.