Predictors of mortality and outcomes after retrograde endovascular angioplasty in patients with peripheral artery disease.

Introduction: Endovascular revascularization (ER) techniques in patients with peripheral artery disease (PAD) have been developed and became more accessible in recent years. The ER is a first-line treatment in the majority of patients with symptomatic PAD. However, data on assessment of predictors of long-term outcomes of retrograde ER in patients with PAD are scarce.
Aim: To evaluate predictors of long-term outcomes of retrograde ER in patients with chronic total occlusion in lower limb arteries.
Material and Methods: We analyzed data of 834 patients who underwent retrograde ER. Baseline clinical characteristics and procedural data were collected. Patients were followed up for 36 months, and the primary endpoint was all-cause mortality.
Results: All patients were symptomatic and had failed antegrade ER. The procedural success rate was 92%. Cumulative all-cause mortality was 13.4% at 36-month follow-up. In multivariate analysis history of stroke, Rutherford category, chronic limb ischemia, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD) and previous ER of other lesion were independent predictors of a higher mortality rate after 36 months (hazard ratio (HR) for stroke 2.4, 95% confidence interval (CI): 1.55-3.66; p = 0.0002; HR for age per 10 years 1.37, 95% CI: 1.15-1.64; p = 0.0002; HR for Rutherford category 1.63, 95% CI: 1.35-1.98; p < 0.0001, HR for chronic limb ischemia 0.44, 95% CI: 0.25-0.8, p = 0.007; HR for CKD 1.73, 95% CI: 1.14-2.56, p = 0.01; HR for COPD 2.4, 95% CI: 1.5-3.7, p = 0.0004; HR for previous ER 0.59, 95% CI: 0.35-0.94, p = 0.02).
Conclusions: History of stroke, Rutherford category, chronic limb ischemia, CKD, COPD, and previous ER of other lesion were independently associated with increased risk of all-cause death.
Competing Interests: The authors declare no conflict of interest.