title: Long-term follow-up after endovascular revascularisation for acute limb ischaemia--a retrospective single-centre cohort.
abstract: BACKGROUND
  We evaluated the long-term outcome after endovascular revascularisation for acute limb ischaemia (ALI).
  
  
  METHODS
  From a prospectively maintained database, 318 endovascular interventions for ALI were identified between 2004 and 2010. Event history and survival were analysed using the Kaplan-Meier method and Cox regression. Endpoints were target vessel revascularisation (TVR), non-target extremity revascularisation (NTER), amputation, major vascular events, coronary artery revascularisation and amputation-free survival.
  
  
  RESULTS
  Follow-up data of 303 patients (mean age 68.5 ± 12.7 years, 40% female) were available. The mean follow-up time was 38.7 ± 26.2 months. TVR was performed in 40.1 ± 2.9% at 1 year and 66.5 ± 3.8% at 5 years. NTER at 1 and 5 years were 7.1 ± 1.5% and 29.2 ± 4%, respectively. The proportion of patients who needed major or minor amputation was 4.3 ± 1.2% after 1 year and 9 ± 2.1% after 5 years. Amputation-free survival at 1 year was 90.3 ± 1.8% and 74.8 ± 3.2% at 5 years. Coronary artery disease (HR 2.22, 95% CI 1.33 to 3.7, p = 0.002) and atrial fibrillation (HR 2.56, % CI 1.3 to 5.04, p = 0.007) were independently associated with a worse amputation-free survival. The cumulative proportion surviving one year following acute limb ischemia was 95.4 ± 1.2% and 79.7 ± 3.1% after 5 years.
  
  
  CONCLUSIONS
  Long-term amputation-free survival after successful revascularisation for ALI is high; negative predictors are coronary artery disease and atrial fibrillation.
authors.affiliation: 1 Clinic for Angiology, University Hospital Zurich, Switzerland.
authors.forename: Fabian
authors.initials: F
authors.lastname: Johner
authors.affiliation: 1 Clinic for Angiology, University Hospital Zurich, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Clemens
authors.affiliation: 1 Clinic for Angiology, University Hospital Zurich, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Husmann
authors.affiliation: 1 Clinic for Angiology, University Hospital Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Thalhammer
authors.affiliation: 2 Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.affiliation: 1 Clinic for Angiology, University Hospital Zurich, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Amann-Vesti
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome
keywords: Angioplasty; acute limb ischaemia; amputation-free survival; target vessel revascularisation