In-hospital outcomes in patients with critical limb ischemia and end-stage renal disease after revascularization

CRITISCH collaborators

17 Citations (Scopus)


Objective Analysis of in-hospital outcomes in patients treated for critical limb ischemia (CLI) and end-stage renal disease (ESRD) compared to CLI patients with normal renal function. Methods A subgroup analysis of the German CRITISCH registry, a prospective multicenter registry, assessing the first-line treatment strategies in CLI patients in 27 vascular centers in Germany was performed. The study cohort was divided into ESRD patients (n = 102) and patients with normal renal function (n = 674; glomerular filtration rate >60/mL/min/1.73 m2). The following first-line treatment strategies were assessed: endovascular therapy (EVT), bypass surgery, patch plasty, and no vascular intervention (conservative treatment, primary amputation). Uni- and multivariate analyses were performed to identify differences between groups as to six end points: amputation or death (composite end point), amputation, death, hemodynamic failure, major adverse cardiac and cerebrovascular events, and reintervention. Results Differences between the ESRD and non-ESRD group were found regarding the applied first-line therapy (P =.016): The first-line treatment strategies in ESRD patients were EVT in 64% (n = 65), bypass surgery in 13% (n = 13), patch plasty in 11% (n = 11), and no vascular intervention in 13% (n = 13). In non-ESRD patients, EVT was applied in 48% (n = 326), bypass surgery in 27% (n = 185), patch plasty in 13% (n = 86), and no vascular intervention in 11% (n = 77). For ESRD patients, a noticeably increased risk of the composite end point (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.19-5.79; P =.017), amputation (OR, 3.14; 95% CI, 1.35-7.31; P =.008), and hemodynamic failure (OR, 2.19; 95% CI, 1.19-4.04; P =.012) was observed. Conclusions CLI patients on dialysis represent a challenging cohort prone to in-hospital death, amputation, and hemodynamic failure. Two-thirds of these high-risk patients are treated with EVT. Present data suggest that this modality is generally considered as the most favorable treatment option in this patient subgroup.

Original languageEnglish
JournalJournal of Vascular Surgery
Issue number4
Pages (from-to)966-973
Number of pages8
Publication statusPublished - 01.04.2016

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)


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