Lower Extremity Amputation Risk Factors Associated With Elevated Ankle Brachial Indices and Radiographic Arterial Calcification

Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário

“…20 In turn, arterial calcification and distal vascular incompressibility in diabetics are considered prognostic factors of amputation equally as important as the ankle-brachial index. 21 The present study identified that reduced hematocrit and hemoglobin levels were significantly more likely to be present in patients who underwent major amputations compared to those subjected to minor amputations. A similar publication, involving only patients with occlusive peripheral arterial disease, observed a significantly higher risk of major amputation (odds ratio [OR] = 1.56) and of death and amputation (OR = 1.58) at 1 year among those with anemia, in relation to those who had normal hemoglobin levels.…”

Contrast-Enhanced Ultrasound Reveals Exercise-Induced Perfusion Deficits in Claudicants

“…The ankle to brachial index can be normal and pedal pulses palpable while proximal resting ischemia and even gangrene is present [28–31]. More frequently, the presence of medial calcific disease, common in people with diabetes, results in vessel rigidity that falsely elevates the ABI, rendering this measure extremely unreliable [32]. …”

Diabetes Is Associated With Decreased Limb Survival in Patients With Critical Limb Ischemia: Pooled Data From Two Randomized Controlled Trials

“…An ABI .1.4 is probably related to medial artery calcification (MAC), leading to poorly compressible, stiffened arteries. MAC is more often seen in patients with DM and end-stage renal disease (15)(16)(17)(18). Several studies have reported an association between an elevated ABI and amputation (18)(19)(20).…”