title: Results of surgical interventions for critical limb ischemia due to vasculitis or collagen-tissue related disease.
abstract: BACKGROUND
  In this study, we aimed to clarify both systemic and local prognosis after surgical interventions for critical limb ischemia (CLI) due to vasculitis or connective tissue related disease, and to search for any risk factors that can worsen the prognosis.
  
  
  METHODS
  One hundred and ninety three patients that underwent surgical interventions for CLI between 2005 and 2014 were followed up for a median of 2.7 years. The patients were grouped into a group with vasculitis or connective tissue related disease (V) or with atherosclerosis (control: C). Two groups were retrospectively reviewed and compared.
  
  
  RESULTS
  Thirty-one patients were grouped into the V group. At three years after intervention, V group showed significantly higher survival rate compared to C group (89% vs. 73%). On the other hand, limb survival rate after bypass surgery was significantly lower (74% vs. 94%), due to lower patency of the bypassed graft. Within V group, preoperative skin perfusion pressure of lower than 20 mmHg showed significantly worse prognosis of the limb. (HR 1.8; P=0.01) Regarding specific diseases, systemic scleroderma, rheumatoid arthritis and systemic lupus erythematosus tended to show worse prognosis.
  
  
  CONCLUSIONS
  Patients with CLI due to vasculitis or connective tissue related disease have a longer life expectancy with lower limb salvage rate that can lead to low quality of the remaining life.
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan - kmaysyamamo@gmail.com.
authors.forename: Kota
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hoshina
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Akai
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Isaji
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Akagi
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyahara
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D003240:Connective Tissue Diseases / Q000150:complications* / Q000175:diagnosis; D016638:Critical Illness; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014657:Vasculitis / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult