Aim of the study
Impact of disease history and prognosis of chronic limb-threatening ischemia
S Iwata, R Suzuki, Y Hosoi, Y Tanaka, M Tan, K UrasawaTo evaluate the clinical outcome of inframalleolar occlusive disease and its associated pre-operative risk factors including the duration of DM and HD.
Introduction
➢ Inframalleolar disease is known as leading to poor limb outcomes between CLTI patients.1
➢ MAC (medial artery calcification) frequently exists in inframalleolar artery among CLTI patients receiving HD and DM, which can cause technical failure after EVT and major amputation.2-4
➢ The relationships between HD and DM history with IM occlusive disease remains to be identified.
Materials and methods
➢ A multicenter, retrospective, observational study examined patients with CLTI (Rutherford classification 5-6) treated by EVT for de-novo inframalleolar occlusions with a GLASS P2 modifier in 4 Japanese hospitals from November 2017 to August 2022.
➢ 109 limbs in 101 patients were included in this study.
Conclusion
➢ Among CLTI patients examined with a GLASS P2 modifier, duration of DM and HD were associated with a lower 1-year AFS rate.
1.Meloni M, et al. Diabetes Res Clin Pract 2019;152:9-15. 2.Ferraresi R, et al. J Endovasc Ther 2021;28:194-207. 3.Sato Y, et al. Eur J Vasc Endovasc Surg 2022;63:852-863. 4.DiBartolomeo AD, et al. J Vasc Surg 2023;78:1286-1291. DM, diabetes mellitus; HD, haemodialysis; CLTI, chronic limb threatening ischemia; EVT, endovascular therapy; GLASS, Global Limb Anatomical Staging System; HR, hazard ratio; CI, confidence interval; WIfI, Wound, Ischemia, and Foot Infection; MAC, medial artery calcification; SAD, small artery disease; AFS, Amputation-free survival.