TY - JOUR
T1 - Arterial calcification and long-term outcome in chronic limb-threatening ischemia patients
AU - Konijn, Louise Cd
AU - Takx, Richard Ap
AU - de Jong, Pim A
AU - Spreen, Marlon I
AU - Veger, Hugo Tc
AU - Mali, Willem PThM
AU - van Overhagen, Hendrik
N1 - Funding Information:
The original PADI study received an unrestricted research grant from Dutch Society of Interventional Radiology . All authors of this current post-hoc study declare that they have received no grants, contracts, other forms of financial supports or relationships with the industry relevant to this paper.
Publisher Copyright:
© 2020 The Author(s)
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
Funding Information:
The original PADI study received an unrestricted research grant from Dutch Society of Interventional Radiology . All authors of this current post-hoc study declare that they have received no grants, contracts, other forms of financial supports or relationships with the industry relevant to this paper.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/11
Y1 - 2020/11
N2 - PURPOSE: Within five years after presentation 50-60% of patients with chronic limb-threatening ischemia (CLI) have died or had an amputation. We assessed the predictive value of lower extremity arterial calcification on computed tomography (CT) characteristics on both 7-years amputation-free survival and 10-years all-cause mortality in patients with CLI.METHOD: Included were 89 CLI patients (mean age 73.1 ± 11.6 years) who underwent a CT angiography of the lower extremities. In the femoropopliteal and crural arteries based on a CT score the following calcification characteristics were assessed: severity, annularity, thickness and continuity. The predictive value of different arterial calcification characteristics was analysed by age- and sex-adjusted multivariate Cox regression analysis.RESULTS: Complete annular calcifications were common (femoropopliteal 43.7%, n = 38; crural, 63.2%, n = 55). Mean survival was 278.4 weeks (95% CI 238.77-318.0 weeks). Patients with complete annular calcifications had a higher all-cause 10-year mortality (femoropopliteal unadjusted HR 1.64, p = 0.04 and adjusted for age and sex HR 1.68, p = 0.04; crural unadjusted HR 1.92, p = 0.02, adjusted for age and sex HR 2.29, p = 0.006) than patients with other calcification characteristics.CONCLUSIONS: Annularity of calcification of both femoropopliteal and crural arteries is a predictor for 10-year all-cause survival, its hazard being even higher than the traditional prognostic risk factors for CLI and therefore could be involved in the poor survival of these patients.
AB - PURPOSE: Within five years after presentation 50-60% of patients with chronic limb-threatening ischemia (CLI) have died or had an amputation. We assessed the predictive value of lower extremity arterial calcification on computed tomography (CT) characteristics on both 7-years amputation-free survival and 10-years all-cause mortality in patients with CLI.METHOD: Included were 89 CLI patients (mean age 73.1 ± 11.6 years) who underwent a CT angiography of the lower extremities. In the femoropopliteal and crural arteries based on a CT score the following calcification characteristics were assessed: severity, annularity, thickness and continuity. The predictive value of different arterial calcification characteristics was analysed by age- and sex-adjusted multivariate Cox regression analysis.RESULTS: Complete annular calcifications were common (femoropopliteal 43.7%, n = 38; crural, 63.2%, n = 55). Mean survival was 278.4 weeks (95% CI 238.77-318.0 weeks). Patients with complete annular calcifications had a higher all-cause 10-year mortality (femoropopliteal unadjusted HR 1.64, p = 0.04 and adjusted for age and sex HR 1.68, p = 0.04; crural unadjusted HR 1.92, p = 0.02, adjusted for age and sex HR 2.29, p = 0.006) than patients with other calcification characteristics.CONCLUSIONS: Annularity of calcification of both femoropopliteal and crural arteries is a predictor for 10-year all-cause survival, its hazard being even higher than the traditional prognostic risk factors for CLI and therefore could be involved in the poor survival of these patients.
KW - All-cause mortality
KW - Amputation-free survival
KW - Chronic limb-threatening ischemia
KW - Computed tomography
KW - Intimal calcification
KW - Medial calcification
KW - Peripheral artery disease
KW - Prediction models
UR - http://www.scopus.com/inward/record.url?scp=85091642648&partnerID=8YFLogxK
U2 - 10.1016/j.ejrad.2020.109305
DO - 10.1016/j.ejrad.2020.109305
M3 - Article
C2 - 33007520
SN - 0720-048X
VL - 132
JO - European Journal of Radiology
JF - European Journal of Radiology
M1 - 109305
ER -