Worse Limb Prognosis for Indirect versus Direct Endovascular Revascularization only in Patients with Critical Limb Ischemia Complicated with Wound Infection.

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Presentation transcript:

Worse Limb Prognosis for Indirect versus Direct Endovascular Revascularization only in Patients with Critical Limb Ischemia Complicated with Wound Infection and Diabetes Mellitus O. Iida, M. Takahara, Y. Soga, Y. Yamauchi, K. Hirano, J. Tazaki, T. Yamaoka, N. Suematsu, K. Suzuki, Y. Shintani, Y. Miyashita, M. Uematsu European Journal of Vascular and Endovascular Surgery Volume 46, Issue 5, Pages 575-582 (November 2013) DOI: 10.1016/j.ejvs.2013.08.002 Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 1 Prognostic impact of indirect endovascular therapy (EVT). The rate of freedom from major adverse limb event (MALE) was estimated by the Kaplan–Meier method. Patients undergoing indirect EVT (dotted line, n = 307) had a poorer prognosis than those undergoing direct EVT (solid line, n = 411) (p = .041 by log rank test). European Journal of Vascular and Endovascular Surgery 2013 46, 575-582DOI: (10.1016/j.ejvs.2013.08.002) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 2 Prognostic impact of indirect endovascular therapy (EVT) and elevated C-reactive protein (CRP) levels. The study population was stratified into four groups according to indirect/direct EVT and CRP levels. The rate of freedom from major adverse limb event (MALE) in each subgroup was estimated by the Kaplan–Meier method. Compared to patients undergoing direct EVT for critical limb ischemia (CLI) with CRP <3 mg/dL (blue solid line, n = 297), patients undergoing indirect EVT for CLI with CRP ≥3 mg/dL (red dotted line, n = 114) had an increased risk for MALE (p < .001 by the log rank test). On the other hand, the patients undergoing indirect EVT for CLI with CRP <3 mg/dL (red solid line, n = 116) and the patients undergoing direct EVT for CLI with ≥3 mg/dL (blue dotted line, n = 191) had a similar risk for MALE, compared to the reference subgroup (blue solid line) (p = .467 and 0.789, respectively). European Journal of Vascular and Endovascular Surgery 2013 46, 575-582DOI: (10.1016/j.ejvs.2013.08.002) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 3 Prognostic impact of the coexistence of indirect endovascular therapy (EVT) and elevated C-reactive protein (CRP) levels and the presence of diabetes mellitus. The study population was stratified into four groups according to the coexistence of indirect EVT and elevated CRP levels (≥3 mg/dL) and the presence of diabetes mellitus. The rate of freedom from major adverse limb event (MALE) in each subgroup was estimated by the Kaplan–Meier method. Compared to the non-diabetic patients without the coexistence of indirect EVT and CRP levels ≥3 mg/dL (i.e. the non-diabetic patients who underwent direct EVT and/or had CRP levels <3 mg/dL) (blue solid line, n = 159), the diabetic patients with the coexistence of indirect EVT and CRP ≥3 mg/dL (red dotted line, n = 95) had an increased risk for MALE (p < .001 by the log rank test). On the other hand, the diabetic patients without the coexistence (red solid line, n = 21) and the non-diabetic patients with the coexistence (blue dotted line, n = 443) had a similar risk for MALE, compared to the reference subgroup (blue solid line) (p = .844 and 0.334, respectively). European Journal of Vascular and Endovascular Surgery 2013 46, 575-582DOI: (10.1016/j.ejvs.2013.08.002) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions