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Home > Vascular Annual Meeting > RR18. Comparable Limb Salvage, Patency, and...

RR18. Comparable Limb Salvage, Patency, and Survival Rates Following Open and Endovascular Revascularizations in African-Americans

Hasan H. Dosluoglu1, Purandath Lall1, Linda M. Harris2, Maciej L. Dryjski2
1VA Western NY Healthcare System, SUNY at Buffalo, Buffalo, NY; 2SUNY at Buffalo, Buffalo, NY

OBJECTIVES: African-Americans (AA) have been reported to have poorer early and late patency and limb salvage (LS) rates following bypass procedures. The goal of this study is compare the results of AA and Caucasians (CAU) who present with symptomatic peripheral arterial disease (PAD).

METHODS: All AA and CAU patients who presented with symptomatic PAD between 06/2001-06/2008 were included.

RESULTS: Of the 698 patients (799 limbs), 93 were AA, and 706 were CAU. AA were more likely to be non-ambulatory, have poorer functional capacity (≤4 METS), renal failure, dialysis-dependence, lower albumin levels and present with gangrene, whereas CAU had more CAD, hyperlipidemia, and COPD (Table 1). Significantly more AA had primary amputation (PA, 14% vs 6%, p<0.001). Of those who underwent revascularization, 62% and 61% in AA and CAU groups had endovascular procedures. Infrapopliteal and multilevel interventions were significantly more frequent in AA (Table 1). Perioperative morbidity and mortality were similar. Patency rates, limb salvage and survival were similar in AA and CAU who underwent revascularization (Table 2). Multivariate analysis showed diabetes, gangrene, infrapopliteal interventions and functional capacity independently predicted limb loss, whereas race did not.

CONCLUSIONS: Among patients presenting with symptomatic PAD, AA patients were more likely to have poorer functional status, renal failure, present with gangrene and have lower albumin levels than CAU patients, and were more likely to undergo PA. However, survival, limb salvage and patency rates were similar following open and endovascular revascularizations, although AA were more likely to have infrapopliteal and multilevel interventions.

AUTHOR DISCLOSURES: H.H. Dosluoglu, None; P. Lall, None; L.M. Harris, None; M.L. Dryjski, None.

Table 1.

Table 2.