Normal view MARC view ISBD view

Presence of a patent pedal arch is the primary predictor of transmetatarsal amputation healing and limb salvage.

MedStar author(s):

Akbari, Cameron M

, MHVI

Glousman, Brandon

, MWHC

, Vascular Surgery Integrated Residency

0741-5214

Name of journal: Journal of vascular surgeryAbstract: CONCLUSION: In this series of patients undergoing TMA and arteriography, with appropriate GLASS staging, we have demonstrated that patency of the pedal arch is a significant predictor of healing and limb salvage. GLASS femoral-popliteal and infra-popliteal did not predict TMA healing. Copyright � 2023. Published by Elsevier Inc.METHODS: Consecutive patients within our institution who underwent a TMA and a lower extremity arteriogram between 2012 to 2020 were included. Patients who healed their TMA were compared against those who did not. Using pre-operative and peri-operative patient factors in addition to the Global Limb Anatomical Staging System (GLASS) and evaluation of the tibial runoff vessels, a multivariate analysis was used to define predictors of TMA healing (at 30 days and one year). In those patients who underwent intervention including those with repeat interventions, their post-intervention GLASS stage was calculated. All patients were followed by the vascular surgeon using standard ultrasound surveillance and clinical follow up. Once the predictors were identified, subsequent analysis was performed to correlate 30-day and 1-year limb salvage rates.OBJECTIVE: The transmetatarsal amputation (TMA) is a durable and important functional limb salvage option. We herein present our results in identifying angiographic predictors of TMA healing using single-institution retrospective data.RESULTS: 89 patients met inclusion criteria for the study period. There was no difference in GLASS femoral-popliteal and infra-popliteal stages in those that healed a TMA vs. those that did not. After multivariate regression analysis, the presence of a patent pedal arch vs. a non-intact arch had 5.5 greater odds of TMA healing at 30-days but not at 1-year. Additionally, the presence of patent arch was strongly associated with limb salvage at both 30-days (86% vs. 49%, p <0.01) and 1-year (79% vs. 49%, p <0.01).All authors: Glousman BNOriginally published: Journal of Vascular Surgery. 2023 Jan 27Original year of publication: 2023Fiscal year: FY2023 Fiscal year of original publication: | FY2023 | | | Original title: Presence of a Patent Pedal Arch is the Primary Predictor of Transmetatarsal Amputation Healing and Limb Salvage.Digital Object Identifier:

https://dx.doi.org/10.1016/j.jvs.2023.01.184

Date added to catalog:

Holdings ( 0 )
Title notes ( 5 )

No physical items for this record

CONCLUSION: In this series of patients undergoing TMA and arteriography, with appropriate GLASS staging, we have demonstrated that patency of the pedal arch is a significant predictor of healing and limb salvage. GLASS femoral-popliteal and infra-popliteal did not predict TMA healing. Copyright � 2023. Published by Elsevier Inc.

METHODS: Consecutive patients within our institution who underwent a TMA and a lower extremity arteriogram between 2012 to 2020 were included. Patients who healed their TMA were compared against those who did not. Using pre-operative and peri-operative patient factors in addition to the Global Limb Anatomical Staging System (GLASS) and evaluation of the tibial runoff vessels, a multivariate analysis was used to define predictors of TMA healing (at 30 days and one year). In those patients who underwent intervention including those with repeat interventions, their post-intervention GLASS stage was calculated. All patients were followed by the vascular surgeon using standard ultrasound surveillance and clinical follow up. Once the predictors were identified, subsequent analysis was performed to correlate 30-day and 1-year limb salvage rates.

OBJECTIVE: The transmetatarsal amputation (TMA) is a durable and important functional limb salvage option. We herein present our results in identifying angiographic predictors of TMA healing using single-institution retrospective data.

RESULTS: 89 patients met inclusion criteria for the study period. There was no difference in GLASS femoral-popliteal and infra-popliteal stages in those that healed a TMA vs. those that did not. After multivariate regression analysis, the presence of a patent pedal arch vs. a non-intact arch had 5.5 greater odds of TMA healing at 30-days but not at 1-year. Additionally, the presence of patent arch was strongly associated with limb salvage at both 30-days (86% vs. 49%, p <0.01) and 1-year (79% vs. 49%, p <0.01).

English