Abstract 10846: Long-term Clinical Outcomes and Predictors of Incomplete Wound Healing Status After Endovascular Therapy for Patients With Critical Limb Ischemia Due to Isolated Below-the-knee Lesions
Background: Little is known about the prognosis of patients who could not be achieved complete wound healing for critical limb ischemia (CLI) after endovascular therapy (EVT). Therefore, we investigated the long-term clinical outcomes and predictors of incomplete wound healing status after successful EVT for patients with CLI due to isolated BTK lesions.
Methods: This study was a multicenter retrospective study. From March 2004 to March 2012, 574 consecutive patients (first treated limbs, Rutherford 5 or 6, 69.5% man, 71.0 ± 10.7 years old, achieved the complete wound follow-up) who underwent successful EVT with CLI due to de novo isolated BTK lesions were retrospectively selected and analyzed. Between incomplete wound healing status and complete wound healing status, overall survival (OS), amputation free survival (AFS), limb salvage (LS), repeat revascularization, freedom from major adverse limb events (MALE: repeat revascularization for the limb or major amputation [defined as above-the-ankle amputation]) were examined by the Kaplan Meier method and the log-rank test.
Results: Mean follow-up duration was 20.1 ± 10.6 months. At 5 years, OS, AFS and LS, freedom from MALE were significantly lower in the incomplete wound healing status (15.8% vs. 59.4%, P<.0001; 6.7% vs. 49.6%, P<.0001; 49.0% vs. 97.0%, P<.0001; 11.0% vs. 48.0%, P<.0001 respectively).On the other hands, freedom from repeat revascularization did not differ significantly between two groups (40.1% vs. 49.3%, P=0.21). On multivariate analysis, Rutherford 6, low level of serum albumin, non angiosome-based EVT, residual stenosis were the independent predictors of the incomplete wound healing status after EVT with CLI due to isolated BTK lesions. Death caused by cardiovascular death, sepsis and pneumonia were more frequent in the incomplete wound healing status.
Conclusion: The prognosis of CLI patients with incomplete wound healing status after EVT for isolated BTK disease was extremely poor.
- © 2013 by American Heart Association, Inc.