Evidence map›Paper›PMID 40066218›Full record

ArticleCirculation reports2025

Clinical Features of Acute on Chronic Lower Limb Ischemia and the Importance of Underlying Arterial Disease for Revascularization.

Tsutomu Doita, Shinsuke Kikuchi, Yuya Tamaru, Takayuki Uramoto, Kazuki Takahashi, Keisuke Kamada, Seima Ohira, Hiroya Moriyama, Takamitsu Tatsukawa, Naoya Kuriyama and 5 more

Abstract read
In one paragraph

Article in Circulation reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Tsutomu DoitaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Shinsuke KikuchiDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Yuya TamaruDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Takayuki UramotoDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Kazuki TakahashiDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Keisuke KamadaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Seima OhiraDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Hiroya MoriyamaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Takamitsu TatsukawaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Naoya KuriyamaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Yuri YoshidaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Daiki UchidaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.
Keisuke MiyakeDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine Osaka Japan.
Shigeru MiyagawaDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine Osaka Japan.
Nobuyoshi AzumaDepartment of Vascular Surgery, Asahikawa Medical University Hokkaido Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute lower extremity limb ischemia (ALI) is a common vascular surgery emergency, primarily caused by embolism or atherosclerotic in situ thrombosis-acute on chronic limb ischemia (AoCLI). This study aimed to examine the clinical features and treatment challenges of AoCLI. Methods and Results: Between January 2014 and December 2022, 73 patients with AoCLI (n=35) or embolic ALI (n=38) were analyzed. The time from ALI onset was significantly longer (P<0.01), and the rate of contralateral diseases was higher in AoCLI than embolic ALI (P<0.01). Treatment and intraoperative findings showed higher rates of failed thrombectomy (P=0.027), difficulty in crossing lesions (P<0.01), defined as failure of Fogarty catheter crossing despite guidewire navigation and requirement of the balloon angioplasty for the lesions, additional revascularization (P<0.01), and multi-segment treatment (P<0.01) in AoCLI. In multivariate analysis, unfavorable factors for endovascular therapy (EVT) were >2.5 days from ALI onset (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.0-2.0), non-atrial fibrillation (OR 4.2; 95% CI 1.0-16.7), and collateral development (OR 9.0; 95% CI 1.0-81.5). Rates of failed EVT were 0% for no factors, 18% for 1 factor, 43% for 2 factors, and 90% for 3 factors. Conclusions: AoCLI had more complex and multi-segment arterial lesions, making limb perfusion restoration difficult. The unfavorable factors for EVT could help stratify the optimal treatment of ALI in emergency settings.

Indexed as

Acute lower limb ischemiaAcute on chronic limb ischemiaArterial thrombosis

Identifiers

PMID40066218
PMCPMC11890296

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.