743 Validation of the Global Limb Anatomic Staging System in Chronic Limb Threatening Ischaemia Using the Bypass Versus Angioplasty in Severe Ischaemia of the Leg Prospective Cohort Study

Aim To evaluate the application of an angiographic tool (Global Limb Anatomic Staging System - GLASS) designed to predict immediate treatment failure (ITF) and other clinical outcomes in patients undergoing revascularisation for chronic limb threatening ischaemia (CLTI) using a large prospective registry. Method The Bypass versus Angioplasty in Severe Ischaemia of the Leg Prospective Cohort Study (BASIL-PCS) collated data regarding 152 patients with CLTI who presented to a large academic vascular unit and underwent infrainguinal endovascular treatment (EVT). Each patient was given a GLASS score based on review of appropriate imaging by blinded, trained assessors. The relationship of GLASS with the following clinical outcomes was assessed; immediate technical failure (ITF), amputation free survival (AFS), major adverse limb event (MALE), limb salvage (LS), and overall survival (OS). Results A higher technical failure rate was associated with increasing GLASS stage in those undergoing endovascular treatment (EVT), ITF rate for GLASS I, II and III were 1/21 (4.8%), 4/35 (11.4%) and 17/76 (22.4%) respectively. There was no significant relationship between GLASS and other clinical outcomes (AFS, MALE, LS, and OS). Conclusions In our cohort ITF was correlated with increasing GLASS stage which is in line with the assumptions of the Global Vascular Guidelines (GVG). However, GLASS did not predict other longer term clinical outcomes and requires further evaluation in a larger cohort.