Impact of Renal Impairment on Immediate and Midterm Results of Endovascular Management of Peripheral Arterial Disease

Abstract

Background: Peripheral artery disease (PAD) is highly common and more severe among patients who have chronic kidney disease (CKD), due to vascular calcification. This calcification complicates diagnosis and treatment, requiring tools like the PACSS scoring system for accurate assessment. This research aimed to assess the impact of renal impairment on different modalities and outcomes of endovascular management of femoro-popliteal atherosclerotic arterial disease.

Methods: This single-center prospective cohort study included 47 patients with chronic kidney disease (CKD) who presented with disabling claudication or critical limb ischemia due to femoro-popliteal atherosclerotic disease and were treated using an endovascular approach. All patients were subjected to radiological investigation [arterial duplex was done before and after endovascular procedure].

Results: Analysis of the endovascular procedure revealed that patients with high Ca score had high incidence of stenting by a rate of 64.7 % (P=0.033). Analysis of the endovascular procedure revealed that patients with high Ca score had high incidence of stenting by a rate of 64.7 % (P=0.033). During follow up, the clinical presentation of the patients had also impact on the clinical outcome. The patients presented with major tissue loss had poor clinical outcome in comparison with other patients (P=0.028).

Conclusions: Chronic kidney disease (CKD) is linked to unfavorable 12-month clinical outcomes in patients undergoing endovascular revascularization for peripheral arterial disease (PAD).