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Clinical outcomes of patients with and without chronic kidney disease undergoing endovascular revascularization of infrainguinal peripheral artery disease: Insights from the XLPAD registry
Author(s) -
Kabir Ryan,
Vuppala Suchith,
Liu Yulun,
Tejani Ishita,
Weideman Rick,
Banerjee Avantika,
Tsai Shirling,
Huffman Lynn,
Niazi Khusrow,
Brilakis Emmanouil S.,
Shishehbor Mehdi H.,
Banerjee Subhash
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29491
Subject(s) - medicine , revascularization , hazard ratio , kidney disease , critical limb ischemia , amputation , surgery , cardiology , vascular disease , confidence interval , myocardial infarction
Objectives The purpose of the present study was to define clinical outcomes of chronic kidney disease (CKD) patients undergoing endovascular revascularization of infrainguinal peripheral artery disease (PAD). Background CKD is an established predictor of advanced PAD. However, clinical outcomes for these patients following endovascular revascularization remain inadequately defined. Methods Using the ongoing multicenter Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851), we analyzed all‐cause death, target limb amputation, and need for repeat revascularization for patients with and without CKD undergoing infrainguinal endovascular revascularization between the years 2005 and 2018. Results Of 3,699 patients, 15.1% ( n = 559) had baseline CKD. CKD patients had significantly higher incidence of heavily calcified lesions (48.4% vs. 38.1%, p < .001) and diffuse disease (66.9% vs. 61.5%, p = .007). Kaplan–Meier analysis showed significant differences between CKD and non‐CKD patient outcomes at 12 months for freedom from target limb amputation (79.9% vs. 92.7%, p < .001) and all‐cause death (90.1% vs. 97.6%, p < .001). However, freedom from target vessel revascularization was similar between the groups. After adjusting for baseline comorbidities in the CKD and non‐CKD groups, the hazard ratios for target limb amputation and death at 12 months were 2.28 (95% confidence interval or CI 1.25–4.17, p < .001) and 4.38 (95% CI 2.58–7.45, p < .001), respectively. Conclusions Following endovascular revascularization for infrainguinal PAD, CKD was an independent predictor of all‐cause death and target limb amputation at 12 months.