Chronic Limb-Threatening Ischemia in Patients with Type 2 Diabetes: Revascularization Index as a Predictor for Primary Endovascular Intervention Outcome

Figures & data

Table 1 Major Lower Limb Amputation and Secondary Revascularization According to Co-Morbidities and WIfI Clinical Stages

Comorbidities	n (%)	Major Lower Limb Amputation			Secondary Revascularization
		Yes	No	p-value	Yes	No	p-value
		n (%)	n (%)		n (%)	n (%)
History of hypertension				0.100			0.196
Yes	133 (71.1)	30 (22.6)	103 (77.4)		67 (50.4)	66 (49.6)
No	54 (28.9)	6 (11.1)	48 (88.9)		21 (38.9)	33 (61.1)
History of Hyperlipidemia				0.138			0.768
Yes	103 (55.1)	24 (23.3)	79 (76.7)		47 (45.6)	56 (54.4)
No	84 (44.9)	12 (14.3)	72 (85.7)		41 (48.8)	43 (51.2)
End-Stage Renal Disease*				0.005			0.864
Yes	31 (16.6)	12 (38.7)	19 (61.3)		14 (45.2)	17 (54.8)
No	156 (83.4)	24 (15.4)	132 (84.6)		74 (47.4)	82 (52.6)
Smoking				0.002			0.038
Yes	125 (66.8)	29 (26.9)	79 (73.1)		58 (53.7)	50 (46.3)
No	62 (33.2)	7 (8.9)	72 (91.1)		30 (38.0)	49 (62.0)
Ischemic Heart Disease				0.041			0.554
Yes	97 (51.8)	21 (26.2)	59 (73.8)		40 (50.0)	40 (50.0)
No	90 (48.2)	15 (14.0)	92 (86.0)		48 (44.9)	59 (55.1)
SVS WIfI Stages**				0.035			0.213
Very low/low Risk	37 (19.7)	3 (8.1)	34 (91.9)		16 (43.2)	21 (56.8)
Moderate Risk	69 (36.9)	11 (15.9)	58 (84.1)		28 (40.6)	41 (59.4)
High Risk	81 (43.3)	22 (27.2)	59 (72.8)		44 (54.3)	37 (45.7)

Notes: *End-stage renal failure on regular hemodialysis, **SVS WIfI stage = The Society of Vascular Surgery (Wound, Ischemia and foot Infection) clinical stage, P-value of <0.05 is considered significant.

Table 2 Gender Variations in Relation to the Mean Values of Age, Pre-Atherosclerotic Severity Scores and the Revascularization Index

Mean Value of Tested Variable (±SD)	Male	Female	P-value
	140	47
Age	61.22 (±11.04)	69.74 (±9.48)	0.000
Pre Atherosclerotic Severity Score	14.54 (±3.6)	15.55 (±3.74)	0.089
Revascularization Index	1.34 (±0.37)	1.35 (±0.21)	0.51

Table 3 Distribution of Atherosclerotic Lesions in the Arteries and the Frequency of Intervention in Each Artery

	Score 0: Patent	Score 1: 1–30% Occlusion	Score 2: 31–49% Occlusion	Score 3: 50–99% Occlusion	Score 4: 100% Occluded	Frequency of HRAL	Frequency of Intervention
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Common Iliac Artery	69 (36.9)	67 (35.8)	16 (8.6)	14 (7.5)	21 (11.2)	35 18	35 (19.3)
External Iliac Artery	70 (37.4)	83 (44.4)	26 (13.9)	7 (3.7)	1 (0.5)	8 4	7 (3.7)
Common Femoral Artery	109 (58.3)	66 (35.3)	12 (6.4)	0	0	0	0 (0)
Superficial Femoral Artery	13 (7.0)	49 (26.2)	41 (21.9)	34 (18.2)	50 (26.7)	84 44	76 (40.6)
Popliteal Artery	17 (9.1)	70 (37.4)	27 (14.4)	49 (26.2)	24 (12.8)	73 39	65 (34.8)
Anterior Tibial Artery	14 (7.5)	43 (23.0)	45 (24.1)	49 (26.2)	36 (19.3)	85 45.5	44 (23.5)
Posterior Tibial Artery	18 (9.6)	28 (15.0)	38 (20.3)	56 (29.9)	47 (25.1)	103 55	64 (34.2)
Peroneal Artery	25 (13.4)	78 (41.7)	35 (18.7)	36 (19.3)	13 (7.0)	49 26	7 (3.7)

Table 4 The 6 Month, 1-Year, 2-Year, and 5-Year Rates of Secondary Revascularization, Major Amputation, and Death

	Frequency	Rate at 6 Months	Rate at 1 Year	Rate at 2 Years	Rate at 5 Years
Needed Secondary Angioplasty	88 (47.1%)	8.1%	15.7%	36.8%	86.4%
Underwent Major Amputation	36 (19.3%)	5.9%	8.6%	14.6%	45.1%
Death	41 (21.9%)	0.5%	1.6%	9.2%	73.2%

Table 5 The Association of Revascularization Index (RI) and Pre-Revascularization Atherosclerotic Severity Score (Pre-ASS) with the Outcome Parameters in the Cox Proportional-Hazards Model*

	Death				Amputation				Secondary Revascularization
	HR	95% CI		P-value	HR	95% CI		P-value	HR	95% CI		P-value
RI Quartiles
<1.21	0.35	0.10	1.24	0.103	5.80	1.25	26.97	0.025	10.92	3.14	38.00	<0.001
1.21–1.299	0.61	0.19	1.92	0.395	1.86	0.39	8.91	0.438	14.77	4.21	51.79	<0.001
1.3–1.499	0.72	0.23	2.20	0.561	0.66	0.11	4.00	0.651	3.47	0.95	12.59	0.059
≥1.5	1.00				1.00				1.000
Pre-ASS Quartiles
<12	0.81	0.23	2.86	0.748	0.51	0.08	3.29	0.476	0.58	0.21	1.62	0.298
12–13.9	0.56	0.20	1.61	0.283	0.21	0.06	0.76	0.017	0.93	0.49	1.79	0.838
14–16.9	1.14	0.51	2.55	0.753	0.68	0.31	1.45	0.313	0.67	0.40	1.14	0.138
≥17	1.00				1.00				1.00

Note: *Adjusted for age, gender, hypertension and hyperlipidemia.