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<p>The incidence of chronic limb-threatening ischemia, the most severe form of peripheral artery disease, is increasing. A considerable portion are deemed “no-option” patients and have high rates of limb loss and death, with even worse outcomes in underrepresented populations. This study aimed to delineate real-world, contemporary outcomes in an observational study of no-option chronic limb-threatening ischemia patients. The composite primary end point was amputation-free survival (defined as freedom from death and above-ankle amputation) at 1 year. A total of 180 patients with no-option chronic limb-threatening ischemia were included from 22 centers across the US. The median age was 70 years (IQR, 61–78 years), 33% were women, 39% were Black, and 11% were Hispanic/Latino. Comorbidities included 76% with diabetes, 33% with heart failure, and 25% with end-stage renal disease. At 1 year, the amputation-free survival rate was 37%, 45% had major amputation, and 33% died. Additionally, two-thirds of the remaining patients had persistent non-healing ulcers, 44% had minor amputation, and 83% required ambulatory assistance. In this severely diseased population, approximately half of patients underwent major amputation and one-third died within a year, highlighting the pressing need for innovative interventions for limb salvage.</p>

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Contemporary outcomes in no-option chronic limb-threatening ischemia

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月8日

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  • Anahita Dua,
  • Richard J. Powell,
  • Arthur C. Lee,
  • Nelson Bernardo,
  • Joseph L. Mills,
  • Lucas Ferrer Cardona,
  • Matthew C. Bunte,
  • Jorge L. Martínez-Trabal,
  • Samir Ghandour,
  • Sagar S. Gandhi,
  • Zola N’Dandu,
  • Peter A. Schneider,
  • Daniel Clair,
  • Mehdi H. Shishehbor

摘要

The incidence of chronic limb-threatening ischemia, the most severe form of peripheral artery disease, is increasing. A considerable portion are deemed “no-option” patients and have high rates of limb loss and death, with even worse outcomes in underrepresented populations. This study aimed to delineate real-world, contemporary outcomes in an observational study of no-option chronic limb-threatening ischemia patients. The composite primary end point was amputation-free survival (defined as freedom from death and above-ankle amputation) at 1 year. A total of 180 patients with no-option chronic limb-threatening ischemia were included from 22 centers across the US. The median age was 70 years (IQR, 61–78 years), 33% were women, 39% were Black, and 11% were Hispanic/Latino. Comorbidities included 76% with diabetes, 33% with heart failure, and 25% with end-stage renal disease. At 1 year, the amputation-free survival rate was 37%, 45% had major amputation, and 33% died. Additionally, two-thirds of the remaining patients had persistent non-healing ulcers, 44% had minor amputation, and 83% required ambulatory assistance. In this severely diseased population, approximately half of patients underwent major amputation and one-third died within a year, highlighting the pressing need for innovative interventions for limb salvage.