Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Understanding the Impact of COVID-19 on Angioplasty Service and Outcome of Patients Treated for Critical Limb Ischaemia: A Single-Centre Retrospective Cohort Study

Version 1 : Received: 2 June 2023 / Approved: 5 June 2023 / Online: 5 June 2023 (08:37:51 CEST)

A peer-reviewed article of this Preprint also exists.

Rodway, A.D.; Harris, J.; Hanna, L.; Allan, C.; Casal, F.P.; Giltinan, C.; Dehghan-Nayeri, A.; Santos, A.; Whyte, M.B.; Ntagiantas, N.; Walton, I.; Brown, R.; Skene, S.S.; Pankhania, A.; Field, B.C.T.; Maytham, G.D.; Heiss, C. Understanding the Impact of COVID-19 on Angioplasty Service and Outcome of Patients Treated for Chronic Limb-Threatening Ischaemia: A Single-Centre Retrospective Cohort Study. Biomedicines 2023, 11, 2034. Rodway, A.D.; Harris, J.; Hanna, L.; Allan, C.; Casal, F.P.; Giltinan, C.; Dehghan-Nayeri, A.; Santos, A.; Whyte, M.B.; Ntagiantas, N.; Walton, I.; Brown, R.; Skene, S.S.; Pankhania, A.; Field, B.C.T.; Maytham, G.D.; Heiss, C. Understanding the Impact of COVID-19 on Angioplasty Service and Outcome of Patients Treated for Chronic Limb-Threatening Ischaemia: A Single-Centre Retrospective Cohort Study. Biomedicines 2023, 11, 2034.

Abstract

We evaluated the impact of COVID-19 restriction on the angioplasty service and outcome of critical limb ischaemia (CLI) patients undergoing lower limb angioplasty in a UK secondary care setting. Consecutive patients were analysed retrospectively. Pre-COVID-19 (08/2018-02/2020), 106 CLI-patients (91% Fontaine 4; 60% diabetes mellitus) and during COVID-19 (03/2020-07/2021) 94 patients were treated (86% Fontaine 4; 66% diabetes mellitus). While the average monthly number of patients treated did not change, the proportion of day cases significantly increased (53% to 80%) and hospitalised patients decreased. Patients treated in <=14/5 days after referral significantly increased to 64/63%. Kaplan-Meier survival analysis (30-day/1-year) showed that neither wound healing nor mortality were significantly changed during COVID-19. In day cases, 1-year but not 30-day major amputations significantly increased, and clinically driven target lesion revascularisation decreased during COVID-19. 1-year mortality was significantly worse in hospitalised as compared to day cases (14% vs 43%) at similar wound healing rates (83% vs 84%). The most frequent known-causes-of-death were infectious disease (64%) and cardiovascular (21%) was less frequent. Despite COVID-19 restriction a safe and effective angioplasty service was maintained while shortening waiting times. Very high mortality rates in hospitalised patients may indicate that CLI should be treated more aggressively and earlier.

Keywords

day-case angioplasty; critical limb ischaemia; peripheral artery disease

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0


×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.