Endovascular intervention in Taiwanese patients with critical limb ischemia: Patient outcomes in 333 consecutive limb procedures with a 3-year follow-up

• Published in: Journal of the Formosan Medical Association Vol. 113; no. 10; pp. 688 - 695
• Main Authors: Huang, Hsuan-Li, Chou, Hsin-Hua, Wu, Tien-Yu, Chang, Shang-Hung, Tsai, Yueh-Ju, Hung, Shuo-Suei, Lu, Chun-Te, Cheng, Shih-Tsung, Yeh, Kuan-Hung, Chang, Heng-Chia
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.10.2014; Elsevier
• Subjects: Aged; Aged, 80 and over; Amputation; critical limb ischemia; endovascular intervention; Female; Follow-Up Studies; Humans; Internal Medicine; Ischemia - surgery; Kaplan-Meier Estimate; Limb Salvage; Lower Extremity - blood supply; Male; Middle Aged; outcomes; Peripheral Vascular Diseases - surgery; Prospective Studies; Risk Factors; Taiwan; Treatment Outcome; Taiwan; outcomes; endovascular intervention; critical limb ischemia
• ISSN: 0929-6646
• DOI: 10.1016/j.jfma.2012.10.022

Background/Purpose Midterm outcomes of endovascular intervention (EVI) for critical limb ischemia (CLI) have not been previously reported in Taiwan. This study assessed the safety, feasibility, and patient-oriented outcomes for CLI patients after EVI. Methods From June 2005 to December 2011, 270 patients underwent EVI for CLI of 333 limbs. Primary patency (PP), assisted primary patency (AP), limb salvage, sustained clinical success (SCS), secondary SCS (SSCS), and survival were assessed using Kaplan-Meier analysis. Results The procedural success rate was 89%, and the periprocedural mortality and major complication rates within 30 days were 0.6% and 6.9%, respectively. During the mean follow-up time of 27 ± 20 months (1–77), 64 patients died and 25 legs required major amputation. Eighty-one percent of the patients with tissue loss had wound healing at 6 months and 75% of the patients were ambulatory, with or without assisting devices, at 1 year. The overall survival and limb salvage rates at 3 years were 70% and 90%, respectively. The PP and AP at 1 and 3 years were 58% and 37% and 79% and 61%, respectively. The SCS and SSCS were 65% and 46% and 80% and 64% at 1 and 3 years, respectively. Conclusion In Taiwan, EVI was a safe and feasible procedure for CLI patients, with a high procedural success rate and lower complication rate. Sustained limb salvage and clinical success can be afforded with an active surveillance program and prompt intervention during midterm follow-up.