ArticleActa Cardiologica Sinica2025
Clinical Characteristics and Angioplasty Outcomes in Lower Extremity Artery Disease Patients with Normal Ankle-Brachial Index: A Clinical Conundrum.
Article in Acta Cardiologica Sinica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The resting ankle-brachial index (ABI) is widely used to diagnose lower extremity artery disease (LEAD). However, some LEAD patients have a normal ABI yet require percutaneous transluminal angioplasty (PTA). Methods: This was a retrospective study of consecutive LEAD patients who underwent PTA. The patients were classified into two groups based on the ABI of the limb that underwent PTA: the ABI-normal group (ABI 0.91-1.40), and ABI-abnormal group (ABI ≤ 0.90 or > 1.40). The primary endpoints were major adverse cardiovascular and cerebral events (MACCEs) and major adverse limb events (MALEs). Results: Of the 334 patients (mean age: 70 ± 12 years, 60% male), 69 (21%) had a normal ABI, and 265 (79%) had an abnormal ABI. After a median follow-up of 1.5 (0.6-3.1) years, 84 (25%) patients reached the primary or secondary endpoints. The ABI-normal group had a higher proportion of males (73% vs. 57%, p = 0.02) and a higher prevalence of chronic kidney disease (78% vs. 56%, p < 0.01). Angiography revealed less severe lesions in the femoropopliteal artery (p < 0.01) and a lower rate of stent deployment (15% vs. 31%, p < 0.01) in the ABI-normal group than in the ABI-abnormal group. However, the incidence rates of MACCEs (29% vs. 24%, p = 0.56) and MALEs (23% vs. 28%, p = 0.63) were comparable in the two groups. Conclusions: LEAD patients with a normal ABI often have less severe above-the-knee artery lesions but similar poor outcomes, highlighting the need for additional hemodynamic assessments and increased clinical attention.
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