F-10 | Predictors of Adverse Events Following Endovascular Revascularization of Acute Limb Ischemia: Outcomes of the National Cardiovascular Data Registry Peripheral Vascular Intervention Registry

Acute limb ischemia (ALI) is a vascular emergency associated with high rates of limb loss and mortality. As the incidence of ALI has declined over the previous decade and there is greater use of novel endovascular devices, estimation of contemporary rates and predictors of adverse in-hospital outcomes remains needed. Patients who had peripheral vascular intervention performed for the indication of ALI in the National Cardiovascular Data Registry Peripheral Vascular Intervention Registry between 2014 and 2020 were included. The primary outcome was a composite of death from any cause and major amputation during the index hospitalization. Multivariable logistic regression was employed to identify predictors of the composite outcome. There were 3,541 endovascular procedures performed during the study period. Of these, 132 (3.7%) resulted in death and 77 (2.2%) resulted in major amputation during hospitalization. Thrombolysis catheters were used in 24.9% and thrombectomy catheters in 3.6%. Predictors of the composite outcome and odds ratios (OR) are presented in the Figure. Significant predictors of death or amputation included severe lung disease (OR 1.72), Rutherford Class IIb (OR 2.44), and end stage renal disease (OR 3.94). Patients with pre-existing medical comorbidities and those with diminished limb viability were more likely to suffer adverse outcomes due to acute limb ischemia. Adverse event rates remain high for this condition despite its declining incidence.