Femoral artery percutaneous revascularization for patients with critical limb ischemia: Outcomes compared to patients with claudication over 2.5 years

Todoran, Thomas M, Connors, Gerard, Engelson, Brian A., Sobieszczyk, Piotr S., Eisenhauer, Andrew C. and Kinlay, Scott (2012) Femoral artery percutaneous revascularization for patients with critical limb ischemia: Outcomes compared to patients with claudication over 2.5 years. Vascular Medicine, 17 3: 138-144. doi:10.1177/1358863X12440141


Author Todoran, Thomas M
Connors, Gerard
Engelson, Brian A.
Sobieszczyk, Piotr S.
Eisenhauer, Andrew C.
Kinlay, Scott
Title Femoral artery percutaneous revascularization for patients with critical limb ischemia: Outcomes compared to patients with claudication over 2.5 years
Journal name Vascular Medicine   Check publisher's open access policy
ISSN 1358-863X
Publication date 2012-06
Sub-type Article (original research)
DOI 10.1177/1358863X12440141
Open Access Status Not Open Access
Volume 17
Issue 3
Start page 138
End page 144
Total pages 7
Place of publication Glen Head, NY, United States
Publisher Westminster Publications
Collection year 2013
Language eng
Abstract Patients with critical limb ischemia have higher rates of death and amputation after revascularization compared to patients with intermittent claudication. However, the differences in patency after percutaneous revascularization of the superficial femoral artery are uncertain and impact the long-term risk of amputation and function in critical limb ischemia. We identified 171 limbs from 136 consecutive patients who had angioplasty and/or stenting for superficial femoral artery stenoses or occlusions from July 2003 through June 2007. Patients were followed for primary and secondary patency, death and amputation up to 2.5 years, and 111 claudicants were retrospectively compared to the 25 patients with critical limb ischemia. Successful percutaneous revascularization occurred in 128 of 142 limbs (90%) with claudication versus 25 of 29 limbs (86%) with critical limb ischemia (p = 0.51). Overall secondary patency at 2.5 years was 91% for claudication and 88% for critical limb ischemia. In Cox proportional hazards models, percutaneous revascularization for critical limb ischemia had similar long-term primary patency (adjusted hazard ratio = 1.1, 95% CI = 0.4, 2.6; p = 0.89) and secondary patency (adjusted hazard ratio = 1.1, 95% CI = 0.2, 6.0; p = 0.95) to revascularization for claudication. Patients with critical limb ischemia had higher mortality and death rates compared to claudicants, with prior statin use associated with less death (p = 0.034) and amputation (p = 0.010), and prior clopidogrel use associated with less amputation (p = 0.034). In conclusion, percutaneous superficial femoral artery revascularization is associated with similar long-term durability in both groups. Intensive treatment of atherosclerosis risk factors and surveillance for restenosis likely contribute to improving the long-term outcomes of both manifestations of peripheral artery disease.
Keyword Amputation
Angioplasty
Atherosclerosis
Claudication (see intermittent claudication)
Femoral artery
Ischemia
Leg
Longitudinal studies
Outcome assessment (health care)
Peripheral arterial disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
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