436 Infra-Inguinal Angiogplasty Outcomes Audit Through the Lens of GRIFT and Sustainable Delivery

Aim To evaluate the clinical outcomes in patients with Critical Limb Ischaemia (CLI) six months after lower limb arterial angioplasty. To quantify the risk of index limb loss within our cohort and develop a dataset for further audit and quality improvement. Assess surgical resource usage and reconcile with national Getting It Right First Time (GIRFT) strategy and sustainable service delivery. Post-pandemic challenges including increased waiting lists have elevated the risk of angioplasty failure since the 2018 GIRFT Vascular Surgery Report. Method A Health Intelligence dataset was obtained for all lower limb angiograms for a thirteen-month period beginning in January 2022 for a single tertiary centre. Morbidity and mortality data were collected. Results The cohort included 129 patients with a mean age of 71.9 years (range: 39-96 years). Limb salvage was successful in 53% of patients (n=69) with 15% of patients requiring a subsequent amputation (n=19). Of patients who underwent BKA, 50% would receive the BKA within 60 days (n=9). However, the rate of debridement excluding amputation at 6 months post-angioplasty was 18% (n=23). Mortality at 6 months was 25% (n=32). Conclusions Lower limb angioplasty remains crucial for limb salvage and symptom control. Utilisation of pre-angioplasty prognostic scores aid in assessing procedure risk and supporting collaborative decision-making. Review of the CLI patients who required early amputation will allow for development of a stratification/scoring system to predict successful angioplasty, aligning with principles of GIRFT and promoting sustainable medical practice.