Abstract 17842: Relationship Between Novel Angiographic Endpoint of Endovascular Therapy and Clinical Result of Patients with Critical Limb Ischemia

Abstract

Objectives Several reports have been published of the acceptable patency and limb salvage rates following infra-popliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of endovascular therapy (EVT) remains unclear. The aim of this study was to assess the relationship between the appearance of wound blush as an angiographic endpoint and the limb salvage rate in patients with CLI. Methods “Wound blush” was defined as contrast opacification of the vessels around the wound in digital subtraction angiograms obtained immediately after the EVT through the catheter introduced into the popliteal artery. We analyzed the data of 77 consecutive patients (93 limbs) with ischemic ulcerations classified as Rutherford category 5 or 6, who underwent EVT alone, without bypass surgery. Patients were divided into two groups depending on whether or not wound blush was obtained in the angiogram obtained immediately after the procedure, and the ‘freedom from amputation’ rate was compared between the two groups. Results The overall limb salvage rate was 81.7%. The limb salvage rate was significantly higher in the wound blush-positive group than in the wound blush-negative group, and remained so for at least 3 years after the EVT (96.4% vs. 56.8%, P<0.001). Conclusion Presence of wound blush after EVT is associated with higher SPP, both of which are associated with higher rates of limb salvage. Wound blush as an angiographic endpoint in EVT may be a novel predictor of limb salvage in patients with CLI.