Pedal arterial calcification score is associated with hemodynamic change and major amputation after infrainguinal revascularization for chronic limb-threatening ischemia

Liu, Iris H.; Wu, Bian; Krepkiy, Viktoriya; Khoury, Rym El; Ferraresi, Roberto; Reyzelman, Alexander M.; Hiramoto, Jade S.; Schneider, Peter A.; Conte, Michael S.; Vartanian, Shant M.

doi:10.1016/j.jvs.2022.07.009

Cited by 14 publications

(2 citation statements)

References 21 publications

(19 reference statements)

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“…Most diabetic foot wounds can be treated with surgical debridement to achieve the purpose of removing necrotic tissues, reducing infection and preserving healthy tissues, thus creating opportunities for wound repair. However, when the wound or foot infection score is 3 in diabetic foot patients, the risk of toe or lower extremity amputation is very high 57 Wound debridement : Timely and effective wound debridement is crucial to promote wound healing.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of diabetic foot ulcer complicated with lower extremity vasculopathy: Consensus recommendation from the Chinese Medical Association (CMA), Chinese Medical Doctor Association (CMDA)

Wang,

Shi

et al. 2024

Diabetes Metabolism Res

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Diabetic foot ulcer complicated with lower extremity vasculopathy is highly prevalent, slow healing and have a poor prognosis. The final progression leads to amputation, or may even be life‐threatening, seriously affecting patients' quality of life. The treatment of lower extremity vasculopathy is the focus of clinical practice and is vital to improving the healing process of diabetic foot ulcers. Recently, a number of clinical trials on diabetic foot ulcers with lower extremity vasculopathy have been reported. A joint group of Chinese Medical Association (CMA) and Chinese Medical Doctor Association (CMDA) expert representatives reviewed and reached a consensus on the guidelines for the clinical diagnosis and treatment of this kind of disease. These guidelines are based on evidence from the literature and cover the pathogenesis of diabetic foot ulcers complicated with lower extremity vasculopathy and the application of new treatment approaches. These guidelines have been put forward to guide practitioners on the best approaches for screening, diagnosing and treating diabetic foot ulcers with lower extremity vasculopathy, with the aim of providing optimal, evidence‐based management for medical personnel working with diabetic foot wound repair and treatment.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of diabetic foot ulcer complicated with lower extremity vasculopathy: Consensus recommendation from the Chinese Medical Association (CMA), Chinese Medical Doctor Association (CMDA)

Wang,

Shi

et al. 2024

Diabetes Metabolism Res

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“…In the studies conducted by Vartanian and colleagues, it was observed that the MAC score of the foot exhibited a significant association with both major amputation 14 and hemodynamic alterations following revascularization in individuals with chronic limb‐threatening ischemia. 15 In a recent study, So and colleagues conducted an assessment of the DFU characteristics in individuals with stages 3b–5 chronic kidney disease (CKD) and also investigated the associated risk of major amputation. 16 They discovered that the presence of severe MAC significantly increased the likelihood of major amputation (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.43–13.88; p = .010) within the CKD population.…”

Section: Introductionmentioning

confidence: 99%

Pedal medial arterial calcification in diabetic foot ulcers: A significant risk factor of amputation and mortality

Chen,

Gong

et al. 2024

Journal of Diabetes

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AimsPedal medial arterial calcification (MAC) is frequently observed in individuals with diabetic foot ulcers (DFUs). However, the impact of pedal MAC on individuals with DFUs remains uncertain. The main aim of this study was to evaluate the association between pedal MAC with amputation and mortality outcomes.MethodsA prospective, observational cohort study was conducted at West China Hospital from January 2012 to December 2021. Logistic regression analyses, Kaplan–Meier survival method, and Cox proportional hazards models were employed to evaluate the relationship between pedal MAC and amputation as well as mortality.ResultsA total of 979 patients were enrolled in the study. Peripheral artery disease (PAD) was observed in 53% of patients with DFUs, and pedal MAC was found in 8%. Over a median follow‐up of 46 (23–72) months, foot amputation was performed on 190 patients, and mortality occurred in 246 patients. Pedal MAC showed a significant association with amputation both in unadjusted analysis (odds ratio [OR] = 2.98, 95% confidence interval [CI] = 1.86–4.76, p < .001) and after adjusting sex, age, albumin levels, hemoglobin levels, and diabetic retinopathy status (OR 2.29, 95% CI 1.33–3.93, p = .003). The risk of amputation was found to be twofold higher in individuals with PAD and pedal MAC compared to those with PAD alone (OR 2.05, 95% CI 1.10–3.82, p = .024). Furthermore, the presence of pedal MAC was significantly associated with an increased risk of mortality (p = .005), particularly among individuals with DFUs but without PAD (HR 4.26, 95% CI 1.90–9.52, p < .001), rather than in individuals presenting with both DFUs and PAD.ConclusionThe presence of pedal MAC is significantly associated with both amputation and mortality in individuals with DFUs. Moreover, pedal MAC could provide additional value to predict amputation other than PAD.image

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Interventionelle Angiologie

Steiner

2023

Diabetologie

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Pedal arterial calcification score is associated with hemodynamic change and major amputation after infrainguinal revascularization for chronic limb-threatening ischemia

Cited by 14 publications

References 21 publications

Diagnosis and treatment of diabetic foot ulcer complicated with lower extremity vasculopathy: Consensus recommendation from the Chinese Medical Association (CMA), Chinese Medical Doctor Association (CMDA)

Diagnosis and treatment of diabetic foot ulcer complicated with lower extremity vasculopathy: Consensus recommendation from the Chinese Medical Association (CMA), Chinese Medical Doctor Association (CMDA)

Pedal medial arterial calcification in diabetic foot ulcers: A significant risk factor of amputation and mortality

Interventionelle Angiologie

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