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ABS20191006_0002
| Peripheral Vascular Disease and Intervention | |
| The Impact of Critical Limb-Threatening Ischemia (CLTI) Patient Classified with Global Limb Anatomic Staging System (GLASS) Stage After Endovascular Therapy | |
| Takahiro Tokuda1, Yasuhiro Oba2, Ryoji Koshida3, Yoriyasu Suzuki2, Tatsuya Ito2 | |
| Nagoya Heart Center, Japan1, Nagoya heart center, Japan2, Toyohashi Heart Center, Japan3 | |
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Background:
Recently, Society for Vascular Surgery guideline recommends evaluating anatomic pattern with use of Global Limb Anatomic Staging System (GLASS) in Chronic Limb-Threatening Ischemia (CLTI) patients.The aim of this study is to validate GLASS stage into CLTI patients on hemodialysis (HD) and investigate the impact of GLASS stage.
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Methods:
Between April 2009 and December 2017, we performed EVT for 151 limbs (249 lesions) in CLTI patients on HD. GLASS was defined as Femoro-Poplieal (FP) and Infra-Popliteal (IP) segments separately graded (0-4), then combined into three GLASS stages for the limb (1-3). We divided them into three GLASS stages with using this system. We compared the clinical outcome at 1 year between three groups (GLASS1(G1),GLASS2(G2), and GLASS3).
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Results:
There were no significant differences between three groups in terms of patient and lesion backgrounds except presence of CTO. (G1vs. G2 vs. G3; 22% vs 43% vs 88%, p < 0.01) The rate of technical success was lowest in the GLASS 3 group. (G1 vs. G2 vs. G3; 95% vs 92% vs 23%, p < 0.01)Multivariate analysis revealed that CTO (HR 5.7, p <0.01), calcification (HR7.9, p < 0.01), and GLASS 3 (HR 21.3, p < 0.01) were the predictors of technical unsuccess, diabetes and wound blush (HR 5.9, p < 0.01 and HR 2.9,p = 0.03) were the predictors of non-wound healing.
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Conclusion:
GLASS stage in CLTI patient on HD could predict technical success although it was not associated with predicting wound healing in this study. Futher study is needed to reveal imapct of GLASS stage.
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