Falsely high ankle-brachial index predicts major amputation in critical limb ischemia

Silvestro, Antonio; Diehm, Nicolas; Savolainen, Hannu; Do, Do-Dai; Vögelea, Jolanda; Mahler, Felix; Zwicky, Samuel; Baumgartner, Iris (2006). Falsely high ankle-brachial index predicts major amputation in critical limb ischemia. Vascular medicine, 11(2), pp. 69-74. London: Sage 10.1191/1358863x06vm678oa

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Falsely high ankle-brachial index (ABI) values are associated with an adverse clinical outcome in diabetes mellitus. The aim of the present study was to verify whether such an association also exists in patients with chronic critical limb ischemia (CLI) with and without diabetes. A total of 229 patients (74 +/- 11 years, 136 males, 244 limbs with CLI) were followed for 262 +/- 136 days. Incompressibility of lower limb arteries (ABI > 1.3) was found in 45 patients, and was associated with diabetes mellitus (p = 0.01) and renal insufficiency (p = 0.035). Limbs with incompressible ankle arteries had a higher rate of major amputation (p = 0.002 by log-rank). This association was confirmed by multivariate Cox regression analysis (relative risk [RR] 2.67; 95% CI 1.27-5.64, p = 0.01). The relationship between ABI > 1.3 and amputation rate persisted after subjects with diabetes and renal insufficiency had been removed from the analysis (RR 3.85; 95% CI 1.25-11.79, p = 0.018). Dividing limbs with measurable ankle pressure according to tertiles of ABI, the group in the second tertile (0.323 < or = ABI < or = 0.469) had the lowest amputation rate (4/64, 6.2%), and a U-shaped association between the occurrence of major amputation and ABI was evident. No association was found between ABI and mortality. In conclusion, this study demonstrates that falsely high ABI is an independent predictor of major amputation in patients with CLI.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Silvestro, A; Diehm, Nicolas Alexander; Savolainen, Hannu Olavi; Do, Dai-Do and Baumgartner, Iris

ISSN:

1358-863X

ISBN:

16886836

Publisher:

Sage

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:45

Last Modified:

06 Dec 2013 13:41

Publisher DOI:

10.1191/1358863x06vm678oa

PubMed ID:

16886836

Web of Science ID:

000239387300001

URI:

https://boris.unibe.ch/id/eprint/18776 (FactScience: 1014)

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