Critical Limb Ischemia: Wound Blush Is the Most Important Objective

Critical Limb Ischemia: Wound Blush The aim of this study was to find the optimal angiographic endpoint for infrapopliteal interventions to be able to predict wound healing.

 

Evidence shows acceptable patency and successful limb salvage in patients with critical limb ischemia after infrapopliteal intervention. However, the optimal angiographic endpoint remains unclear. Is it enough to restore flow in one vessel or is it necessary to treat them all? And we should also consider the angiosome guided revascularization approach.

 

Several studies have been conducted to try answer the question of optimal infrapopliteal angioplasty enpoint in patients with critical limb ischemia. This is a subanalysis of the prospective multicenter registry OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia), that included patients with critical limb ischemia and infrainguinal disease.

 

Researchers analyzed 185 limbs with ischemic ulcers classified as Rutherford 5 or 6 undergoing endovascular treatment.

 

The association of final angiographic outcome and ulcer healing was done using the Cox model.

 

Wound healing rate was 73.5%. The probabilities of proper wound healing were significantly higher in patients with wound blush (79.6% vs. 46.5%; p = 0.01). Wound blush was an independent predictor of wound healing.

 

Conclusion

The presence of wound blush after infrapopliteal intervention was associated with wound healing. Wound blush could be a new angiographic predictor of success in patients with critical limb ischemia

 

Editorial Comment

This new concept complements the angiosome guided approach. In fact, successful angiosome revascularization and ulcer flow restoration may most likely produce wound blush. The benefit of this new concept is that it is far easier to assess in the cath lab and a lot easier to remember (compared to the angiosome), since it reminds us of the myocardial blush of primary PCI.

 

Original Title: Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing.

Reference: Makoto Utsunomiya et al. JACC Cardiovasc Interv. 2017 Jan 23;10(2):188-194.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Transcatheter Pulmonary Valve Implantation with a Self-Expanding Valve: Outcomes at 3 Years

Pulmonary regurgitation (PR) is a common condition in patients who have undergone surgical repair of Tetralogy of Fallot or other pathologies involving the right...

RACE Trial: Effect of Balloon Pulmonary Angioplasty and Riociguat on Right Ventricular Afterload and Function in Chronic Thromboembolic Pulmonary Hypertension

Even though pulmonary endarterectomy is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), up to 40% of patients are not candidates because...

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Pretreatment with DAPT in Acute Coronary Syndrome: An Ongoing Debate?

In acute coronary syndrome (ACS) dual antiplatelet therapy (DAPT) has become a fundamental pillar after percutaneous coronary intervention (PCI), preventing stent thrombosis and acute...

Measuring Post-TAVI Gradients and Their Implications: Are Invasive and Echocardiographic Assessments Comparable?

Transcatheter aortic valve implantation (TAVI) is considered the treatment of choice for a significant proportion of patients with symptomatic aortic stenosis. Outcomes have improved...

Another Blow for Intra-Aortic Balloon Pumo Counterpulsation? Randomized Study on Its Use in Chronic Heart Failure Progressing to Cardiogenic Shock

Cardiogenic shock (CS) remains a condition with extremely high mortality (around 50%). While most therapies for this pathology have been studied in CS secondary...