P1280IMPACT OF HAEMODIALYSIS IN PATIENTS UNDERGOING BYPASS SURGERY FOR PERIPHERAL ARTERY DISEASE WITH CRITICAL LIMB ISCHEMIA - 10-YEAR FOLLOW-UP STUDY -

Abstract Background and Aims Although lower extremities bypass surgery has been commonly performed as the standard option to treat peripheral artery disease with critical limb ischemia (CLI) even in patients on haemodialysis (HD) as well as general population, higher amputation and/or mortality rates still remains major clinical problems after bypass surgery in this population. In this 10-year follow-up study, we investigated the impact of HD on outcomes after surgical revascularization in patients with CLI. Method A total of 464 patients undergoing successfully elective bypass surgery were enrolled. We compared 304 HD patients with 335 limbs and 160 non-HD (NHD) patients with 183 limbs during 10 years follow-up period. Primary outcome was amputation-free survival (AFS) rate defined as freedom rate from composited endpoint with major amputation (limb amputation above ankle level) or all-cause mortality. To minimize the differences of clinical characteristics between the two groups, propensity score-matching with all baseline variables was performed. Results Prevalence of diabetes (55.6% vs. 33.8%), ulcer/gangrene (99.1% vs. 63.5%) and infra-popliteal artery disease (58.9% vs. 32.5%) were significantly higher in HD group compared to NHD group (p<0.0001 in all). Pre-procedural C-reactive protein (CRP) levels was also higher in HD group [14.0 (4.0-51.5) mg/l vs. 7.0 (2.0-34.0) mg/l, p=0.0015]. Inversely, age was younger in HD group than in NHD group (67±9 years vs. 72±8 years, p<0.0001). The 30-day mortality rate was comparable (3.3% in HD group vs. 1.3% in NHD group, p=0.16). During follow-up period (median of 48 months), 53 amputation (17.4%) and 102 death (33.6%) in HD group, and 17 amputation (10.6%) and 23 death (14.4%) in NHD group occurred, respectively. The 10-year AFS rate was significantly lower in HD group compared to NHD group [41.3% vs. 71.3%, hazard ratio (HR) 2.33, 95% confidence interval (CI) 1.64-3.41, p<0.0001). Similarly, limb salvage rate and survival rate was also lower in HD group than in NHD group (72.1% vs. 87.5%, HR 1.90, 95%CI 1.12-3.39, p=0.016, and 51.8% vs. 80.4%, HR 2.78, 95%CI 1.80-4.48, p<0.0001, respectively). In the propensity score-matched cohort, having no significant differences of all baseline characteristics between HD and NHD group (n=125 in each), the 10-year AFS rate and survival rate was still lower in HD group compared to NHD group (53.1% vs. 72.8%, HR 2.11, 95% CI 1.34-3.39, p=0.0012 and 58.6% vs. 84.9%, HR 3.72, 95% CI 2.09-7.06, p<0.0001, respectively). However, the limb salvage rate was statistically comparable between the two group (81.9% vs. 84.2%, HR 1.13, 95%CI 0.55-2.38, p=0.74). In addition, pre-procedural CRP levels could predict major amputation in HD patients (HR 1.06, 95%CI 1.01-1.10, p=0.024) but not NHD patients (HR 1.09, 95%CI 0.93-1.25, p=0.27). Conclusion The long-term AFS rate and survival rate were markedly lower in HD patients compared to NHD patients. However, the limb salvage rate was even between HD and NHD after adjustment for clinical characteristics. These results suggest that detection at the early stage of PAD may potentially improve the poor outcome. Pre-procedural inflammation status may also specifically affects the poor outcome in HD group.

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P1959Impact of hemodialysis in patients undergoing bypass surgery for peripheral arterial disease - 10-year follow-up study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0706 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

Y Kumada ◽

H Ishii ◽

T Oshima ◽

T Sakakibara ◽

R Ito ◽

...

Keyword(s):

Mortality Rate ◽

Propensity Score ◽

Clinical Characteristics ◽

Bypass Surgery ◽

Limb Ischemia ◽

Limb Salvage Rate ◽

Follow Up Study ◽

Propensity Score Adjustment ◽

Salvage Rate

Abstract Background Although lower extremities bypass surgery has been commonly performed as the standard option to treat peripheral artery disease (PAD) even in patients on hemodialysis (HD) as well as general population, poorer prognosis still remains major problems in this specific population. In this 10-year follow-up study, we investigated the impact of HD after surgical revascularization in patients with PAD. Methods A total of 660 patients undergoing successfully bypass surgery were enrolled. Patients with acute limb ischemia were excluded. We compared 392 HD patients with 428 limbs and 268 non-HD (NHD) patients with 296 limbs during 10 years follow-up period. Primary endpoint was defined as major adverse cardiovascular events (MACE) including all-cause death, non-fatal myocardial infarction and stroke. Second endpoint was major adverse limb events (MALE) including any revascularization and major amputation. To minimize the differences of clinical characteristics between the two groups, propensity score adjusting with all baseline variables was performed. Results Prevalence of diabetes (53.3% vs. 35.2%), critical limb ischemia (77.5% vs. 52.1%) and infra-popliteal artery (48.2% vs. 19.6%) were higher in HD group compared to NHD group (p<0.0001 in all), inversely, age was younger in HD group than in NHD group (67±9 years vs. 71±9 years, p<0.0001). The 30-day mortality rate was comparable (3.1% in HD group vs. 1.5% in NHD group, p=0.19). The 10-year event-free survival rate for MACE was significantly lower in HD group compared to NHD group (45.3% vs. 67.4%, p<0.0001) and for MALE (60.0% vs. 80.0%, p=0.0007), respectively. After propensity score adjustment, the freedom rate from MACE was still lower in HD group compared to NHD group [45.6% vs. 67.6%, hazard ratio (HR) 1.89, 95% confidence interval (CI) 1.33–2.72, p=0.0003], however, the rate from MALE was statistically comparable between the two group (65.7% vs. 76.9%, 1.27, 95% CI 0.87–1.90, p=0.21). Furthermore, although the 10-year limb salvage rate was crudely lower in HD group compared to NHD group (80.6% vs. 91.6%, HR 1.57, 95% CI 1.05–2.40, p=0.0027), it was comparable after propensity score adjustment (89.4% vs. 90.1%, HR 1.09, 95% CI 0.59–1.88, p=0.79). Also, the mortality rate was consistently lower in HD patients (adjusted HR 2.37, 95% CI 1.62–3.50, p<0.0001). Conclusion The long-term freedom rate from MACE and mortality was markedly lower in HD patients compared to non-HD patients. However, the rate from MALE, especially limb salvage rate was similar between HD and NHD after adjustment for clinical characteristics. These results suggest that detection at the early stage of PAD may potentially improve the poor outcomes in this high risk population.

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Under-Prescription of Medical Treatment for Peripheral Artery Disease in the Under 50s: A Retrospective Study

Angiology ◽

10.1177/00033197211042155 ◽

2021 ◽

pp. 000331972110421

Author(s):

Simon Soudet ◽

Lorène Bultel ◽

Lamrani Adnane ◽

Thierry Reix ◽

Marie Antoinette Sevestre

Keyword(s):

Medical Treatment ◽

Peripheral Artery Disease ◽

Young Patients ◽

Limb Ischemia ◽

Major Amputation ◽

University Hospital ◽

Acute Limb Ischemia ◽

Peripheral Artery ◽

Artery Disease

Peripheral artery disease (PAD) is a common cause of morbidity and mortality; however, data on its etiology and evolution in patients under 50 years old are scarce. Therefore, we performed a retrospective analysis of data from medical records, including cardiovascular risk factors, etiology, medical and surgical treatment, and follow-up. We included all patients with PAD aged between 18 and 50 years attending our university hospital between 2005 and 2015. Of the 87 patients included, 32 (36%) were women. Smoking was acknowledged by 81 patients (93%), and 37 had dyslipidemia (42.5%). Median follow-up was 24 months (10-59). Recurrence occurred in 41 patients (47.1%), all active smokers, with a median delay of 14 months (7-47). Acute limb ischemia at diagnosis was significantly associated with major amputation, odds ratio (OR) 5.95 (95%CI 1.41-40.90, P = .029), which was needed by 11 patients (12.6%). Treatments included antiplatelet therapy (76; 87.4%), statins (67; 77%), and anti-hypertensives (60; 69%), and 29 (32.1%) patients benefited from vascular rehabilitation. This cohort of relatively young patients with PAD showed a high level of symptom recurrence. Atherosclerosis was the most common etiology. Our study revealed that medical treatment is often under-prescribed in this age group and needs to be improved.

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Are femorodistal bypass grafts for acute limb ischemia worthwhile?

Jornal Vascular Brasileiro ◽

10.1590/s1677-54492009000400003 ◽

2009 ◽

Vol 8 (4) ◽

pp. 294-300

Author(s):

Nader Khandanpour ◽

Felicity J. Meyer ◽

Lily Choy ◽

Jane Skinner ◽

Matthew P. Armon

Keyword(s):

Limb Salvage ◽

Bypass Surgery ◽

Limb Ischemia ◽

Primary Patency ◽

Acute Limb Ischemia ◽

Limb Salvage Rate ◽

Bypass Grafts ◽

Time Points ◽

Vein Grafts ◽

Salvage Rate

Background: It has been shown that autogenous veins are associated with the best limb salvage rates for femorodistal bypass surgery. However, in emergency settings, when an autogenous vein is unavailable, use of synthetic graft material or amputation is a critical decision to make. Objective: To assess the appropriateness of femorodistal bypass grafts for acute limb ischemia in emergency settings. Methods: Patients who underwent emergent bypass and elective femorodistal bypass surgery between 1996 and 2006 were reviewed retrospectively in a single center. Results: There were 147 patients of which 84 had elective and 63 had emergent bypass. The graft patency rates for elective admissions were 44 and 25% vs. 25 and 23% for admissions for acute femorodistal graft surgery at 2 and 4 years, respectively (p < 0.004). Admissions for acute ischemia who were treated with prosthetic grafts had a primary patency of 24 vs. 27% for vein grafts at 2 years and 24 vs. 23% at 4 years (p = 0.33). In the acute femorodistal grafts group, primary patency at 2 years for vein and prosthetic grafts was 27 and 24% as compared to 42 and 32% for electives. These values for cumulative limb salvage rates for elective bypasses were 73 and 63% as compared to 52% at both time points in the acute femorodistal graft group (p < 0.004). In emergency settings, the limb salvage rate for acute femorodistal bypass with prosthetic grafts was 38%, and for vein grafts it was 62% at both time points (p = 0.08). Conclusion: The long term limb salvage rate of 38% suggests that emergent femorodistal revascularization is worthwhile.

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Surgical Treatment of Buerger's Disease

Vascular ◽

10.1258/rsmvasc.12.3.192 ◽

2004 ◽

Vol 12 (3) ◽

pp. 192-197 ◽

Cited By ~ 31

Author(s):

A. Kürşat Bozkurt ◽

Kazim Beşirli ◽

Cengiz Köksal ◽

Gökce Şirin ◽

Lale Yüceyar ◽

...

Keyword(s):

Bypass Surgery ◽

Secondary Patency ◽

Limb Salvage Rate ◽

Buerger’S Disease ◽

Buerger's Disease ◽

Secondary Patency Rate ◽

Severe Ischemia ◽

Salvage Rate ◽

Distal Flow

We aimed to evaluate the characteristics of 198 new patients with Buerger's disease treated surgically in the last decade. We also compared these results with our former series reported in 1993. The records of patients with Buerger's disease who were enrolled in an ongoing investigational protocol between 1991 and 2001 were reviewed. Sympathectomy was carried out in 161 patients and revascularization in 19 patients. The cumulative secondary patency rate was 57.9% for bypass grafts at a mean follow-up of 5.4 years. Clinical outcome following sympathectomy was considered improved in 52.3% of patients, stable in 27.8%, and worse in 19.8%. Seven major and 36 minor amputations were performed, with a limb salvage rate of 95.6%. The aggressiveness of the disease has increased compared with previous series, parallel to the expansion of cigarette consumption. Bypass surgery should be considered for patients with severe ischemia who have target vessels. Sympathectomy still has a role to improve distal flow.

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Role of genetics in peripheral arterial disease outcomes; significance of limb-salvage quantitative locus-1 genes

Experimental Biology and Medicine ◽

10.1177/1535370217743460 ◽

2017 ◽

Vol 243 (2) ◽

pp. 190-197 ◽

Cited By ~ 1

Author(s):

Emmanuel Okeke ◽

Ayotunde O Dokun

Keyword(s):

Quantitative Trait Locus ◽

Limb Salvage ◽

Disease Severity ◽

Peripheral Artery Disease ◽

Quantitative Trait ◽

Molecular Mechanisms ◽

Limb Ischemia ◽

Peripheral Artery ◽

Trait Locus ◽

Artery Disease

Peripheral artery disease is a major health care problem with significant morbidity and mortality. Humans with peripheral artery disease exhibit two major and differential clinical manifestations – intermittent claudication and critical limb ischemia. Individuals with intermittent claudication or critical limb ischemia have overlapping risk factors and objective measures of blood flow. Hence, we hypothesized that variation in genetic make-up may be an important determinant in the severity of peripheral artery disease. Previous studies have identified polymorphism in genes, contributing to extent of atherosclerosis but much less is known about polymorphisms associated with genes that can influence peripheral artery disease severity. This review outlines some of the progress made up-to-date to unravel the molecular mechanisms underlining differential peripheral artery disease severity. By exploring the recovery phenotype of different mouse strains following experimental peripheral artery disease, our group identified the limb salvage-associated quantitative trait locus 1 on mouse chromosome 7 as the first genetic modifier of perfusion recovery and tissue necrosis phenotypes. Furthermore, a number of genes within LSq-1, such as ADAM12, IL-21Rα, and BAG3 were identified as genetic modifiers of peripheral artery disease severity that function through preservation of endothelial and skeletal muscle cells during ischemia. Taken together, these studies suggest manipulation of limb salvage-associated quantitative trait locus 1 genes show great promise as therapeutic targets in the management of peripheral artery disease. Impact statement Peripheral artery disease (PAD) is a major health care problem with significant morbidity and mortality. Individuals with similar atherosclerosis burden do display different severity of disease. This review outlines some of the progress made up-to-date in unraveling the molecular mechanisms underlining differential PAD severity with a focus on the role of the Limb Salvage-associated Quantitative trait locus 1 (LSq-1), a key locus in adaptation to ischemia in PAD.

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Limb Salvage in Early Versus Delayed Revascularization of Acute Lower Limb Ischemia

10.53350/pjmhs211592239 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2239-2241

Author(s):

Salman Jamil Noor ◽

Nauman Imtiaz ◽

Wishal Shaukat ◽

Athar Abbas Gilani ◽

Palwasha Shahid ◽

...

Keyword(s):

Limb Salvage ◽

Lower Limb ◽

Limb Ischemia ◽

P Value ◽

Limb Salvage Rate ◽

Lower Limb Ischemia ◽

Group I ◽

Significant Difference ◽

Group Ii ◽

Salvage Rate

Aim: To compare the limb salvage rate in early versus late presenting patients of Rutherford class IIB acute lower extremity ischemia undergoing revascularization. Study Design: Comparative/observational study Place and duration of study: Department of Surgery, CMH Peshawar from January 2019 to March 2021 Methodology: Twenty eight patients of both genders with ages 20 to 70 years presented with Rutherford class IIB acute lower limb ischemia were enrolled in this study. Patients were divided into two groups. Group I (presented after 6 hours of onset of symptoms) consisted of 20 patients and group II (presented within 6 hours of onset of symptoms) consisted of 8 patients. All the patients underwent femoral embolectomy. Limb salvage rate between both groups was examined at postoperative 3rd month. Data was analyzed by SPSS 24.0. P-value <0.05 was taken as significant. Results: There were 16(80%) male and 4(20%) females with mean age 50.52±11.74 years in group I, in group II 6(75%) were male and 2(25%) were females with mean age 50.08±10.94 years. No significant difference was observed between both groups regarding age and gender with p-value >0.05. In group I, limb salvage found in 19(95%) patients while in group II limb salvage found in 5(62.5%) patients, a significant difference was observed regarding limb salvage rate between both groups (p-value <0.05). Mortality rate was high in group II (delayed presentation) as compared to group I (12.5% Vs 0%) with p-value <0.05. Conclusion: The limb salvage rate was high in early presenting patients than late presenting patients with a significant difference. 30 days mortality rate and amputation rate were significantly high in delayed presentation as compared to early presented cases. Keywords: Acute lower limb ischemia, revascularization, limb salvage

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Complication Rates in Ankle and Hindfoot Charcot Arthropathy Treated with Arthrodesis

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00340 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0034

Author(s):

David M. Macknet ◽

Andrew Wohler ◽

Bruce E. Cohen ◽

J. Kent Ellington ◽

Carroll P. Jones ◽

...

Keyword(s):

Internal Fixation ◽

External Fixation ◽

Limb Salvage ◽

Ankle Arthrodesis ◽

Limb Salvage Rate ◽

Charcot Arthropathy ◽

Non Union ◽

Radiographic Union ◽

Salvage Rate

Category: Diabetes; Ankle; Hindfoot; Other Introduction/Purpose: Charcot arthropathy of the ankle and hindfoot is a progressive and destructive process that can lead to instability and ulceration resulting in significant morbidity. When indicated, the surgical goals are to restore a stable plantigrade foot, reduce the risk of ulceration, and improve function to independent ambulation. Techniques for reconstruction of the neuropathic ankle/hindfoot include external and/or internal fixation. Current literature involving small series of surgical patients has shown a high rate of limb salvage and low complication rate. Our experience has been less promising, although we believe it remains a viable option. It is our goal to report the outcomes of Charcot patients undergoing corrective ankle and hindfoot reconstruction. Methods: We retrospectively reviewed 377 patients undergoing hindfoot and ankle arthrodesis at our institution from 2006- 2017. 77 patients were identified that underwent arthrodesis for Charcot arthropathy, 51 of which met inclusion and exclusion criteria with a minimum one year follow up. 42 had internal fixation as their primary procedure (plate or nail) and 9 patients underwent external fixation with a multi-planar external fixator. Median follow up time was 4 years (IQR 2.97 years). Preoperatively, basic demographic variables, etiology of neuropathy, ulcer status, radiographic measurements, Brodsky classification, and presence of a viable talus were collected and analyzed. Postoperatively, we collected complications including infection, hardware failure, ulceration, recurrent deformity, and nonunion. Reoperation numbers and indications for reoperation were also collected. The primary outcome measure was limb salvage at final follow up. Secondary outcome measures were ambulatory and footwear/bracing status. Results: 11 patients (20%) underwent amputation at final follow up and 26 (47.3%) achieved radiographic union, both of which did not vary by fixation type (p=0.67 and p=0.88). The primary reasons for amputation were persistent infection and non-union. 74.5% of patients developed a post-operative complication and 58.2% had at least one reoperation. 25.5% of patients developed a post- operative infection. Patients with a pre-operative ulceration were more likely to undergo external fixation (p=0.02), but amputation rates did not differ between groups (p>0.99). There was a trend toward increased risk of post-operative infection in the ulceration group (p=0.07). A pre-operative Meary’s angle >25° was more likely to undergo amputation (p=0.04) and less likely to achieve radiographic union (p=0.05). 75.9% of patients were ambulatory at final follow up. Conclusion: Our rates of amputation (20%), post-operative infection (25%), complications (74.5%) and non-union (52%) are higher than previously described. Previous literature has described a near 100% limb salvage rate, but in our report on a large series of Charcot patients undergoing hindfoot/ankle arthrodesis we describe an 80% limb salvage rate. Pre-operative Meary’s angle >25° was predictive of treatment failure.

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Number of infrapopliteal arteries undergoing endovascular treatment is not associated with the limb salvage rate in patients with critical limb ischemia

Journal of Vascular Surgery ◽

10.1016/j.jvs.2016.04.020 ◽

2016 ◽

Vol 64 (5) ◽

pp. 1344-1350 ◽

Cited By ~ 8

Author(s):

Rafael de Athayde Soares ◽

Marcelo Fernando Matielo ◽

Francisco Cardoso Brochado Neto ◽

Marcus Vinícius Martins Cury ◽

Régis Campos Marques ◽

...

Keyword(s):

Endovascular Treatment ◽

Limb Salvage ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Limb Salvage Rate ◽

Infrapopliteal Arteries ◽

Salvage Rate

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Distal bypass with a varicose vein graft for critical limb ischemia: report of a case

Surgical Case Reports ◽

10.1186/s40792-019-0755-x ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Atsushi Guntani ◽

Ryosuke Yoshiga ◽

Shinsuke Mii

Keyword(s):

Varicose Vein ◽

Lower Limb ◽

Vein Graft ◽

Bypass Surgery ◽

Varicose Veins ◽

Graft Infection ◽

Limb Ischemia ◽

Major Amputation ◽

Case Presentation

Abstract Background A saphenous vein complicated with varicose veins is generally thought to be unsuitable for bypass grafting. Case presentation A patient who developed sepsis due to lower limb gangrene was successfully treated by endovascular treatment and bypass surgery using a varicose vein graft. There were no complications, such as occlusion or aneurysm, of the varicose vein graft during the 2-year follow-up period. Conclusions We herein report a case in which bypass surgery with a varicose vein graft was used to avoid major amputation of the lower limb, and the patient recovered markedly from sepsis. If there are no other appropriate autologous veins for revascularization of lower limb gangrene, a varicose vein graft may be useful as a conduit for bypass surgery at risk of graft infection.

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Long term clinical outcome after self-expandable nitinol stent implantation for femoropopliteal occlusive disease in hemodialysis patients

European Heart Journal ◽

10.1093/ehjci/ehaa946.2394 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Ito ◽

S Oshima ◽

H Ishii ◽

H Takahashi ◽

N Umemoto ◽

...

Keyword(s):

Survival Rate ◽

Propensity Score ◽

Clinical Outcome ◽

Limb Salvage ◽

Occlusive Disease ◽

Control Group ◽

Limb Salvage Rate ◽

Nitinol Stent ◽

The Impact ◽

Salvage Rate

Abstract Background Endovascular therapy (EVT) using self-expandable bare nitinol stent (BNS) has been commonly accepted in patients with symptomatic femoropopliteal (FP) occlusive disease. However, poor clinical outcomes in hemodialysis (HD) patients are major problems. We investigated the impact of HD on clinical outcome after EVT in patients with FP disease. Methods A total of 427 consecutive HD patients undergoing successful EVT with BNS for FP disease were enrolled with 157 non-HD patients as a control group. They were followed-up for 5 years. We collected data on target lesion revascularization (TLR) rate, and limb salvage rate as well as survival rate. Propensity-score matching analysis was performed to investigate the true impact of HD on the outcome. Results Critical limb ischemia was observed in 44.0% of overall population (43.0% in HD group vs. 46.8% in non-HD group, p=0.42). Rates of diabetes (67.1% vs. 58.1%, p=0.045) and coronary artery disease (73.5% vs. 58.3%, p=0.0008) were higher, while age (70±10 years old vs. 76±10 years old, p<0.0001) and TASC2 C/D lesion (27.9% vs. 44.6%, p=0.0002) were lower in HD group compared to non-HD group. Pre-procedural C-reactive protein level (0.4mg/l vs. 0.3mg/l, p=0.045) was higher and serum albumin level (3.6g/dl vs. 3.8g/dl, p=0.0045) was lower in HD group than those in non-HD group. The freedom rate from TLR at 5 years was significantly lower in HD group than in non-HD group [47.2% vs. 65.2%, hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.23–2.64, p=0.0017]. The limb salvage rate was comparable between the groups (93.3% vs. 97.1%, HR 1.57, 95% CI 0.58–5.47, p=0.41), while the survival rate was significantly lower in HD group compared to non-HD group (60.6% vs. 86.0%, HR 2.53, 95% CI 1.56–4.36, p=0.0002). After propensity-score analysis, 250 patients (125 in each group) were matched without any difference of clinical characteristics in both groups. In the matched cohort, the freedom rate from TLR was still lower in HD group compared to non-HD group (46.7% vs. 66.6%, HR 2.25, 95% CI 1.35–3.87, p=0.0019). The adjusted limb salvage rate was consistently similar between the groups (95.4% vs. 97.3%, HR 1.10, 95% CI 0.20–5.94, p=0.91). Also, the adjusted survival rate was lower in HD group than in non-HD group (47.6% vs. 89.9%, HR 3.60, 95% CI 1.89–7.44, p<0.0001). Conclusion The freedom rate from TLR at 5 years after BNS implantation for FP disease were significantly lower in HD group than in non-HD group, though the limb salvage rate was similar between the groups. The survival rate was consistently lower in HD group compared to non-HD group. HD status had a great impact on TLR and mortality after EVT with BNS in patients with FP disease. Funding Acknowledgement Type of funding source: None

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