Author + information
- Shin Okamoto,
- Osamu iida,
- Masashi Fujita,
- Tetsuya Watanabe,
- Masaki Awata,
- Takayuki Ishihara,
- Tomoharu Dohi,
- Kiyonori Nanto,
- Takuma Iida,
- Tatsuya Shiraki and
- Masaaki Uematsu
Critical limb ischemia patients with end stage renal disease on dialysis encompass a spectrum of disease severity and comorbidities that greatly impact procedural risk, limb–related outcomes, and patient survival. Risk stratification therefore is relevant from clinical and research perspectives. We assessed and stratified midterm clinical outcomes after endovascular therapy (EVT).
Study comprised a retrospective single–center analysis. Between March 2004 and December 2011, 249 limbs from 191 patients were studied. Rates of amputation–free survival (AFS) and major adverse limb event or perioperative death (MALE+POD) were examined using the Kaplan–Meier method. AFS was defined as above–ankle amputation or any death; MALE as above–ankle amputation or surgical reintervention; and POD as any death within 30 days of EVT. The Cox proportional hazards model was used to determine endpoint independent predictors that were then used for risk stratification analysis.
Patient mean age was 70±10yrs, with 73% diabetics and 76% hypertension. Mean follow–up was 480±432 days. AFS was 69% and 55%, and Freedom from MALE+POD was 82% and 79% at 1 and 2 years, respectively. Factors associated with AFS were ambulatory status and ejection fraction; while those associated with Freedom from MALE+POD were age, ambulatory status and heart failure. Patients with a greater number of risk factors had poorer outcomes.
Despite poor AFS, MALE+POD rate is acceptable after EVT for CLI patients on dialysis. Risk stratification allows endpoint occurrence estimation.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Endovascular Intervention
Abstract Category: 41. TCT@ACC–i2: Carotid, Neurovascular, and Endovascular Intervention
Presentation Number: 2109–224
- 2013 American College of Cardiology Foundation