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Impact of wound blush as an angiographic end point of endovascular therapy for patients with critical limb ischemia  Makoto Utsunomiya, MD, Masato Nakamura,

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Presentation on theme: "Impact of wound blush as an angiographic end point of endovascular therapy for patients with critical limb ischemia  Makoto Utsunomiya, MD, Masato Nakamura,"— Presentation transcript:

1 Impact of wound blush as an angiographic end point of endovascular therapy for patients with critical limb ischemia  Makoto Utsunomiya, MD, Masato Nakamura, MD, Mami Nakanishi, MD, Takurou Takagi, MD, Hidehiko Hara, MD, Kiyoshi Onishi, MD, Tetsuro Yamada, MD, Kaoru Sugi, MD  Journal of Vascular Surgery  Volume 55, Issue 1, Pages (January 2012) DOI: /j.jvs Copyright © 2012 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Example of wound blush (WB). The foot ulcer in patients 1 and 2 is located on the dorsal aspect of the toe. a and b, The digital subtraction angiogram obtained immediately after the endovascular therapy via the catheter introduced into the popliteal artery is WB-negative. Contrast opacification around the wound could not be obtained from the anterior tibial artery or posterior tibial artery, despite successful treatment of both the arteries. c and d, Digital subtraction angiogram shows contrast opacification around the wound obtained from the posterior tibial artery and is WB-positive. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Kaplan-Meier curves for determining the limb salvage rates in the wound blush (WB)-positive and WB-negative groups. The limb salvage rate was 98.2% in the WB-positive group vs 64.9% in the WB-negative group at 1 year (P < .001), 96.4% in the WB-positive group vs 59.5% in the WB-negative group at 2 years (P < .001), and 96.4% in the WB-positive vs 56.8% in the WB-negative group at 3 years (P < .0001). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Kaplan-Meier curves for determining the limb salvage rates in patients in whom direct flow based on the angiosome could be obtained and those in who direct flow to the angiosome could not be obtained. The limb salvage rate was 90.4% in the former group vs 78.0% in the latter group at 1 year (P = .063). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Kaplan-Meier curves for determining the amputation-free survival rates in the wound blush (WB)-positive group and WB-negative group. The amputation-free survival rate was 82.1% in the WB-positive group vs 56.8% in the WB-negative group at 1 year (P = .002), 73.2% in the WB-positive group vs 45.9% in the WB-negative group at 2 years (P = .001), and 69.6% in the WB-positive group vs 37.8% in the WB-negative group at 3 years (P = .001). Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

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