The Impact of Foot Arch Quality in Ultradistal Revascularizations in Patients With Advanced Critical Limb Ischemia
Casilli Giulia, Pasqui Edoardo, Anichini Tommaso, Filippi Federico, de Donato Gianmarco
Vascular Surgery Unit, Department of Medicine, Surgery and Neuroscience, Siena, Italy
Vascular Surgery Unit, Ospedale Misericordia Grosseto, Italy
INTRODUCTION
METHODS & MATERIALS
Between 2020 and 2022, all consecutive patients with a diagnosis of CLTI (Rutherford V-VI) undergoing endovascular BTK revascularization were enrolled.
The study population was divided into three subgroups according to the pedal arch quality. Overall survival, limb salvage and freedom from reintervention were analysed according to arch quality.
RESULTS
A total of 131 patients were included in the analysis (51 F, 80 M, average age 81.1 +- 9.6). At a median follow-up of 25.1±14.6 months 57 deaths were registered. During the follow-up 4 major amputations were registered. 37 reinterventions were registered during follow-up.
The results in terms of survival, freedom from reintervention and limb salvage were analyzed by Kaplan-Meier analysis and compared by log-rank test between the three groups. Analyses for survival and limb salvage showed no statistically significant differences in the three groups (Fig.1-2).
The absent pedal arch group showed a statistically worse trend for freedom from reinterventions with a p value of 0.01 (Fig.3).
Multivariate analysis showed several variables as independent risk factors for the three outcomes (table 1-2-3).
CONCLUSIONS
Pedal arch quality seems to be associated with a higher risk for reintervention in patients with BTK CLTI undergoing endovascular revascularization. The presence of significant comorbidities seems to have a stronger association with worse clinical outcomes with respect to pedal arch status.