Int Angiol. 2026 Mar 18. doi: 10.23736/S0392-9590.26.05521-5. Online ahead of print.
ABSTRACT
BACKGROUND: Evaluate mid-term outcomes, including amputations and mortality, in patients with critical limb-threatening ischemia (CLTI) deemed unsuitable for vein bypass surgery undergoing endovascular treatment in the femoropopliteal segment.
METHODS: A retrospective analysis was conducted including all patients undergoing endovascular treatment for CLTI at a university hospital between 2013-2017. Kaplan-Meier (KM) analyses estimated survival probabilities, and major amputation rates were compared between genders and diabetic versus non-diabetic patients.
RESULTS: One hundred thirty-four patients and 142 limbs were included. 49% of lesions classified as TASC-II D. Technical success was achieved in 95% of limbs. Median follow-up was 24 months (IQR: 13-36 months). 31% had died by study conclusion. KM-estimated freedom from all-cause mortality was 67% (95% CI: 59-77%) at 48 months. The major amputation rate was 25% (N.=35 limbs). KM-estimated freedom from major amputation was 64% (95% CI: 48-85%) at 46 months. There was no significant difference in major amputation-free survival between genders: females 76% (95% CI 63-91%) vs males 70% (95% CI 60-82%) at 36 months. The rate of major amputations was higher in patients with diabetes (19/55, 35% vs. 16/87, 18%, P=0.048), however, KM-estimates showed no statistically significant difference over time, P=0.570.
CONCLUSIONS: In this CLTI cohort unsuitable for vein bypass surgery, 25% underwent major amputation and 31% died following endovascular treatment during a median follow-up of 24 months. Larger comparative studies, including conservative treatment, are needed to define optimal management for complex femoropopliteal lesions.
PMID:41848486 | DOI:10.23736/S0392-9590.26.05521-5
