Impact of Risk Factors on Limb Salvage After Angioplasty in Chronic Critical Lower Limb Ischemia

Abstract

The impact of various general risk factors on long-term results of percutaneous transluminal angioplasty (PTA) in chronic critical lower limb ischemia is poorly known. In a prospective trial 209 PTAs were performed in 103 consecutive patients with 117 limbs with chronic critical ischemia. The general risk factors that might affect the long-term results of PTA in this patient population were reviewed. Among the factors that showed no statistical significance were all associated diseases, smoking history, and medication used. Of the various clinical chemical parameters, only serum high density lipoprotein (S-HDL) cholesterol and plasma fibrinogen had a statistically significant influence on limb salvage rate in Kaplan-Meier analysis. These parameters proved to be significant determinants also in Cox multiple regression analysis when PTA target-vessel-related parameters (peripheral runoff and number of diseased vessels) were also included in the model. Cox model predicts up to 86% one-year limb salvage for the "good" group (one to five diseased lower limb vessels/limb, S-HDL cholesterol > 0.78 mmol/L, plasma fibrinogen < 4.9 g/L).