Background: Peripheral artery disease (PAD) is a chronic condition determining a compromised blood flow to extremities and the most severe form is the critical limb ischemia (CLI). The cornerstone therapy for CLI patients is endovascular revascularization. However, up to one-third of CLI patients are not suitable for surgery and amputation or conservative treatment is most commonly performed.

Aims: We investigate the comorbidities, survival rates and the amputation free-survival (AFL) of patients with CLI.

Methods: From Jan 2015 to Sept 2020 we selected consecutive patients with CLI after being taken to our Angiology Units. Baseline information were collected. The cohort was followed at least 6 months in order to assess primary outcome as amputation free-survive (AFS) and all cause-related death. Data were analysed using chi-squared test or Fisher’s exact test. Survival time were determined by Kaplan-Meier analysis.

Results: Upload as JPEGUpload as JPEGWe evaluated 103 patients with a CLI: table 1 summarized the baseline characteristics. Median age was 76 year and 51 was male; most frequent risk factors were hypertension (91.3%), dyslipidaemia (68%) and history of cardiovascular events (49%). During 5 years follow up, 70 (68%) underwent surgical treatment and 101 (98.7%) infusional treatment. Amputation were performed in 30 (28.9%) patients, 9 above and 21 under the knee respectively. Complete recovered was reached in 26 (25.2%) patients, while 57 (55.3%) have had a wound stabilization. The overall AFS (above or under knee) was 78.7% (SD ± 4,7) (figure 1). 14 (13.5%) patients died during the period: the survival rate for all cause-related death was 88.4% (SD ± 3,7). No differences were found in overall survival comparing amputation vs no amputation subject.

Conclusions: Patients with CLI in charge to a high qualify angiology unit, mortality and amputations are still common treatment, however surgical revascularization and infusional therapy improve the prognosis of these patients.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/clinical-outcomes-and-natural-history-of-critical-limb-ischemia-a-real-world-experience/