Aortic calcium score predicts early outcomes in aortoiliac revascularization

ABSTRACT Objective To evaluate the association between lower limb artery calcium scores in preoperative computed tomography angiography and outcomes of patients with critical limb ischemia who underwent revascularization procedures in the aortoiliac segment. Methods We retrospectively reviewed 1...

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Main Authors: Adalberto Batalha Megale, Nelson Wolosker, Vitoria Magliari Kalil, João Mário Nigro, Carolina Sciammarella Wakisaka, Bianca Oberhuber Dias, Marcelo Passos Teivelis, Marcelo Assis Rocha, Cynthia de Almeida Mendes
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Language:English
Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2025-03-01
Series:Einstein (São Paulo)
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082025000100206&tlng=en
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author Adalberto Batalha Megale
Nelson Wolosker
Vitoria Magliari Kalil
João Mário Nigro
Carolina Sciammarella Wakisaka
Bianca Oberhuber Dias
Marcelo Passos Teivelis
Marcelo Assis Rocha
Cynthia de Almeida Mendes
author_facet Adalberto Batalha Megale
Nelson Wolosker
Vitoria Magliari Kalil
João Mário Nigro
Carolina Sciammarella Wakisaka
Bianca Oberhuber Dias
Marcelo Passos Teivelis
Marcelo Assis Rocha
Cynthia de Almeida Mendes
author_sort Adalberto Batalha Megale
collection DOAJ
description ABSTRACT Objective To evaluate the association between lower limb artery calcium scores in preoperative computed tomography angiography and outcomes of patients with critical limb ischemia who underwent revascularization procedures in the aortoiliac segment. Methods We retrospectively reviewed 14 interventions performed on 11 patients. The calcium score was calculated in segments of the aorta, iliac, femoropopliteal, and below-the-knee arteries. The evaluated outcomes included amputation, patency, death, subsequent revascularization, and readmission. Major adverse limb events were defined as amputation, subsequent revascularization, or readmission. The patients were followed through a 12-month period. Results Higher aortic calcium scores were associated with amputation within 30 days (5,767.6 versus 805.3; p=0.02). Amputation during the first year correlated with a higher below-the-knee arteries calcium score (672.4 versus 163.25; p=0.04). Subsequent revascularization within 30 days was associated with a higher aortic calcium score (3,686.8 versus 645.2; p=0.008), while below-the-knee arteries calcium scores were associated with revascularization within 30 days (155.5 versus 817; p=0.05) and 12 months (158.875 versus 679.4; p=0.019). Readmissions within 1 year were more prevalent with higher below-the-knee arteries calcium scores (882.4 versus 32; p=0.011). Major adverse limb events were related to below-the-knee arteries calcium scores at 30 days (158.875 versus 679.4; p=0.019) and 1 year (12.3 versus 910.1; p=0.002). Conclusion Below-the-knee arteries calcium score is a predictor of long-term revascularization, amputation, readmission, and major adverse limb events. The aortic calcium score was associated with amputation and subsequent revascularization within the first 30 days.
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spelling doaj-art-ae553ef07a4f45cea76767369d5fb2e82025-08-20T03:44:35ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852025-03-012310.31744/einstein_journal/2025ao0527Aortic calcium score predicts early outcomes in aortoiliac revascularizationAdalberto Batalha Megalehttps://orcid.org/0000-0002-6943-5569Nelson Woloskerhttps://orcid.org/0000-0003-1991-3507Vitoria Magliari Kalilhttps://orcid.org/0009-0007-3450-015XJoão Mário Nigrohttps://orcid.org/0009-0005-5744-6067Carolina Sciammarella Wakisakahttps://orcid.org/0009-0008-9426-5638Bianca Oberhuber Diashttps://orcid.org/0009-0003-6938-3951Marcelo Passos Teivelishttps://orcid.org/0000-0002-3648-6773Marcelo Assis Rochahttps://orcid.org/0000-0002-0312-4821Cynthia de Almeida Mendeshttps://orcid.org/0000-0001-9266-8144ABSTRACT Objective To evaluate the association between lower limb artery calcium scores in preoperative computed tomography angiography and outcomes of patients with critical limb ischemia who underwent revascularization procedures in the aortoiliac segment. Methods We retrospectively reviewed 14 interventions performed on 11 patients. The calcium score was calculated in segments of the aorta, iliac, femoropopliteal, and below-the-knee arteries. The evaluated outcomes included amputation, patency, death, subsequent revascularization, and readmission. Major adverse limb events were defined as amputation, subsequent revascularization, or readmission. The patients were followed through a 12-month period. Results Higher aortic calcium scores were associated with amputation within 30 days (5,767.6 versus 805.3; p=0.02). Amputation during the first year correlated with a higher below-the-knee arteries calcium score (672.4 versus 163.25; p=0.04). Subsequent revascularization within 30 days was associated with a higher aortic calcium score (3,686.8 versus 645.2; p=0.008), while below-the-knee arteries calcium scores were associated with revascularization within 30 days (155.5 versus 817; p=0.05) and 12 months (158.875 versus 679.4; p=0.019). Readmissions within 1 year were more prevalent with higher below-the-knee arteries calcium scores (882.4 versus 32; p=0.011). Major adverse limb events were related to below-the-knee arteries calcium scores at 30 days (158.875 versus 679.4; p=0.019) and 1 year (12.3 versus 910.1; p=0.002). Conclusion Below-the-knee arteries calcium score is a predictor of long-term revascularization, amputation, readmission, and major adverse limb events. The aortic calcium score was associated with amputation and subsequent revascularization within the first 30 days.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082025000100206&tlng=enPeripheral arterial diseaseChronic limb-threatening ischemiaAtherosclerosisAngioplastyAmputation, surgicalCalciumLower extremityComputed tomography, angiography
spellingShingle Adalberto Batalha Megale
Nelson Wolosker
Vitoria Magliari Kalil
João Mário Nigro
Carolina Sciammarella Wakisaka
Bianca Oberhuber Dias
Marcelo Passos Teivelis
Marcelo Assis Rocha
Cynthia de Almeida Mendes
Aortic calcium score predicts early outcomes in aortoiliac revascularization
Einstein (São Paulo)
Peripheral arterial disease
Chronic limb-threatening ischemia
Atherosclerosis
Angioplasty
Amputation, surgical
Calcium
Lower extremity
Computed tomography, angiography
title Aortic calcium score predicts early outcomes in aortoiliac revascularization
title_full Aortic calcium score predicts early outcomes in aortoiliac revascularization
title_fullStr Aortic calcium score predicts early outcomes in aortoiliac revascularization
title_full_unstemmed Aortic calcium score predicts early outcomes in aortoiliac revascularization
title_short Aortic calcium score predicts early outcomes in aortoiliac revascularization
title_sort aortic calcium score predicts early outcomes in aortoiliac revascularization
topic Peripheral arterial disease
Chronic limb-threatening ischemia
Atherosclerosis
Angioplasty
Amputation, surgical
Calcium
Lower extremity
Computed tomography, angiography
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082025000100206&tlng=en
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