title: Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing.
abstract: This study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing.
  
  
  
  Several reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear.
  
  
  
  We conducted a subanalysis of the prospective multicenter OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia) registry investigation assessing patients who received infrainguinal EVT for CLI. We analyzed data from 185 limbs with ischemic ulcerations classified as Rutherford class 5 or 6, managed with EVT alone (i.e., not undergoing bypass surgery). The wound healing rate after EVT was estimated by the Kaplan-Meier method. The association between final angiographic data and wound healing was assessed employing a Cox proportional hazards model.
  
  
  
  The overall wound healing rate was 73.5%. The probabilities of wound healing in patients with wound blush obtainment was significantly higher than that of those without wound blush (79.6% vs. 46.5%; p = 0.01). In the multivariate analysis, wound blush obtainment was an independent predictor of wound healing.
  
  
  
  The presence of wound blush after EVT is significantly associated with wound healing. Wound blush as an angiographic endpoint for EVT may serve as a novel predictor of wound healing in patients with CLI.
authors.affiliation: Division of Cardiovascular Medicine, Tokyo Rosai Hospital, Tokyo, Japan. Electronic address: m.utsu0705@gmail.com.
authors.forename: Makoto
authors.initials: M
authors.lastname: Utsunomiya
authors.affiliation: Department of Metabolic Medicine Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Takahara
authors.affiliation: Cardiovascular Division, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.affiliation: Cardiovascular Center, Kikuna Memorial Hospital, Yokohama, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Yamauchi
authors.affiliation: Cardiovascular Center, Morinomiya Hospital, Osaka, Japan.
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.affiliation: Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yokoi
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Yoshimistu
authors.initials: Y
authors.lastname: Soga
authors.affiliation: Department of Plastic and Reconstructive Surgery, School of Medicine, Kyorin University, Mitaka, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ohura
authors.affiliation: Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003287:Contrast Media / Q000008:administration & dosage*; D016638:Critical Illness; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D016523:Foot Ulcer / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D007564:Japan; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012039:Regional Blood Flow; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D003287:Contrast Media
keywords: critical limb ischemia; endovascular therapy; wound healing