NDLI: Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort.

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Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Vircoulon, Marion Boulon, Carine Desormais, Ileana Lacroix, Philippe Aboyans, Victor Bura-Riviere, Alessandra Cambou, Jean-Pierre Becker, François Constans, Joel
Spatial Coverage	France
Description	Country affiliation: France Author Affiliation: Vircoulon M ( 1 Medecine Vasculaire, Hopital St Andre, Bordeaux, France.)
Abstract	BACKGROUND: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. PATIENTS AND METHODS: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). RESULTS: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). CONCLUSIONS: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).
File Format	HTM / HTML
ISSN	03011526
e-ISSN	16642872
Journal	Vasa
Issue Number	3
Volume Number	44
Language	English
Publisher	Hogrefe Verlag
Publisher Date	2015-05-01
Publisher Place	Switzerland
Access Restriction	Open
Subject Keyword	Discipline Cardiology Cardiovascular Agents Therapeutic Use Ischemia Diagnosis Therapy Lower Extremity Blood Supply Terminology As Topic Vascular Surgical Procedures Amputation Adverse Effects Consensus Critical Illness Disease-free Survival Classification Mortality Limb Salvage Predictive Value Of Tests Reoperation Time Factors Comparative Study Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine

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