IFT08. Comparative Study of Short-Term Clinical Outcomes of Single Versus Multiple Infrapopliteal Vessel Angioplasty in Critical Limb Ischemia in Tertiary Referral Center in India

Abstract

Very few studies have examined the impact of the number of infrapopliteal arteries treated on the limb salvage rate and no prospective study has been conducted in an Indian population. Objective of this study was to analyze the short-term clinical outcomes of single versus multiple infrapopliteal vessel angioplasty in critical limb ischemia in Indian population. In this single-center, prospective nonrandomized study, 142 critical limb ischemia patients who underwent successful infrapopliteal angioplasty from June 2017 to May 2018 were divided into two groups based on whether a single vessel (SV group, n = 85) or multiple infrapopliteal vessel (MV group, n = 57) underwent angioplasty and then followed up for 6 months. The end points were wound healing, limb salvage, major adverse cardiac events, and all-cause mortality. Among the 85 patients in the SV and 57 in the MV group, the mean age of the patients was 67 ± 10 years with males being predominant in both. Both groups were equally matched in terms of most comorbidities, except for more there being diabetics in MV group (98.2% vs 89.4%; P = .044). Most patients were in Wound, Ischemia, and Foot infection stage 4 in both groups. In-line flow was achieved more in MV group (84.2% vs 64.7%; P = .011). Type of plantar arch, technical and hemodynamic success and perioperative complications were equal in both. Mean ankle-brachial index, TBI, and transcutaneous partial pressure of oxygen at 6 months were equal in both groups. At 6 months, 71.8% in SV and 61.4% in MV group (P = .196) healed their wound completely at an equal mean wound healing duration (P = .889). Limb salvage was in 85.9% in SV and 84.2% in MV (P = .783). Major adverse cardiac events and mortality were equal in both. Incorporating plantar arch status on wound outcomes, the MV group did not have an advantage in terms of wound healing over SV group in patients with incomplete plantar arch (58.7% vs 76.9%; P = .040) and the duration of healing does not depend on the status of the plantar arch. In the short term, the number of infrapopliteal vessels undergoing angioplasty does not impact the success and rate of wound healing and limb salvage in critical limb ischemia.