Home > Journals > International Angiology > Past Issues > International Angiology 2016 October;35(5) > International Angiology 2016 October;35(5):460-8

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions
Cite this article as

 

ORIGINAL ARTICLES   

International Angiology 2016 October;35(5):460-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Useful predictors for critical limb ischemia in severely ischemic limbs

Takuro SHIRASU, Tetsuro MIYATA, Ayako NISHIYAMA, Takuya MIYAHARA, Katsuyuki HOSHINA, Kunihiro SHIGEMATSU, Toshiaki WATANABE

Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan


PDF


BACKGROUND: The aim of this paper was to determine useful predictors for critical limb ischemia (CLI) occurrence in severely ischemic limbs. The contralateral limbs of patients with unilateral CLI were evaluated, with special respect to pulse volume recording (PVR).
METHODS: Retrospective analysis of 102 consecutive patients (110 limbs) with unilateral CLI. We excluded patients with bilateral CLI, or without PVR data. PVR data were automatically quantitatively expressed as upstroke time (UT) and percentage mean artery pressure (%MAP). The role of PVR parameters was examined in relation to arterial occlusive disease in the lower limbs. Baseline characteristics and non-invasive laboratory data (including Ankle Brachial Index [ABI] and PVR data) were analyzed as predictors for CLI.
RESULTS: After exclusion, 73 contralateral limbs of unilateral CLI patients (mean age, 70±12 years; 51 male, 70%) were investigated. Fifty patients (68%) had diabetes, and 41 patients (56%) were receiving hemodialysis. UT was longer in patients with crural arterial occlusive disease (214±55 versus 183±57 ms, P=0.02), although ABI was not different (P=0.31). In the follow-up of 19±12 months, 25 limbs progressed to CLI, and the cumulative incidence was 28% and 51% at 1 and 3 years, respectively. Multivariate analysis confirmed that abnormal %MAP (hazard ratio 5.9; 95% confidence interval, 1.8-27.0; P<0.01), coronary artery disease (CAD), and hypoalbuminemia were significant risk factors.
CONCLUSIONS: %MAP, CAD, and hypoalbuminemia predicted CLI occurrence in the contralateral limbs of unilateral CLI patients.

top of page