ArticleJournal of vascular research2026
Systemic Inflammatory Indices Predict Survival and Limb Outcomes after Revascularization for Chronic Limb-Threatening Ischemia.
Article in Journal of vascular research, 2026. 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
introductionChronic limb-threatening ischemia (CLTI) carries high morbidity and mortality, yet risk stratification tools after revascularization remain limited. The Systemic Immune-Inflammation Index (SII) and Systemic Inflammatory Response Index (SIRI) have emerged as prognostic markers. This study evaluated their predictive value in CLTI patients undergoing revascularization.
methodsThis retrospective single-center cohort study included 122 CLTI patients undergoing endovascular angioplasty (n = 81) or surgical bypass (n = 41) between 2017 and 2023. Pre-procedural SII and SIRI were calculated from blood counts. Outcomes included: overall survival, major adverse cardiovascular and limb events (MACE/MALE), and limb amputation. Kaplan-Meier analysis, Cox regression with Firth's penalized likelihood adjustment, and C-index analyses were performed.
resultsSurgical bypass was associated with longer median survival than angioplasty (48 vs. 27 months, p = 0.012). Patients in the lowest SII quartile (<492) had significantly improved 84-month survival versus higher quartiles (88.4% vs. 55.1%). Elevated SII remained independently associated with mortality on multivariable analysis. SIRI was higher among patients with adverse events (2.7 vs. 2.0, p = 0.024) but was not independently associated with outcomes. SII demonstrated moderate-to-high predictive performance, with C-indices up to 0.921 in the bypass subgroup.
conclusionPre-procedural SII is independently associated with survival following CLTI revascularization and may aid risk stratification.
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