Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Peripheral Vascular Disease
Paramalleolar Arterial Bollinger Score in the Era of Diabetes and End-Stage Renal Disease – Usefulness for Predicting Operative Outcome of Critical Limb Ischemia –
Mitsuru MatsukuraKatsuyuki HoshinaKunihiro ShigematsuTetsuro MiyataToshiaki Watanabe
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2016 Volume 80 Issue 1 Pages 235-242

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Abstract

Background:The aim of this study was to evaluate the usefulness of paramalleolar arterial Bollinger score (PBS) for predicting postoperative outcome of infra-popliteal bypass surgery for critical limb ischemia (CLI).Methods and Results:A total of 104 consecutive patients (118 limbs) who underwent infra-popliteal (tibial or paramalleolar) arterial bypass surgery with an autologous vein conduit for the treatment of CLI (Rutherford 4–6) between January 2002 and December 2012 were classified according to PBS ≤45 or >45. Postoperative outcome was compared between these groups. Primary outcomes were major adverse limb events plus perioperative death, and amputation-free survival (AFS). The secondary outcomes were overall survival, limb salvage and secondary graft patency. More than 80% of patients had either diabetes mellitus (DM) or end-stage renal disease (ESRD) and 30 patients with 36 limbs had PBS >45. Compared with the PBS ≤45 group, the PBS >45 group had higher CVD and carotid stenosis rate, poor nutrition status and lower malignancy rate. On overall analysis, the PBS >45 group had worse outcome for AFS and survival but this was not statistically significant (P=0.12, NS). In DM or ESRD patients, the PBS >45 group had significantly worse outcome for both AFS (P=0.04, 0.02) and overall survival rate (P=0.04, 0.03).Conclusions:PBS successfully classified CLI patients with DM or ESRD who had worse outcome after infra-popliteal bypass surgery. (Circ J 2016; 80: 235–242)

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© 2016 THE JAPANESE CIRCULATION SOCIETY
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