Efficacy and safety of revascularization in patients with chronic limb-threatening ischemia by kidney function.
Am Heart JAug 5, 2026 (epub)
Jun Young Lee, Gomathy Parvathinathan, Sai Liu et al.
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In 30 seconds
This randomized controlled trial analyzed the efficacy and safety of surgical versus endovascular revascularization in 1,704 patients with chronic limb-threatening ischemia (CLTI) stratified by kidney function. Surgical revascularization was associated with significantly fewer days with major adverse limb events (MALE) or death in non-CKD (-127.8 days) and mild-moderate CKD (-63.2 days), but not in advanced CKD (-16.4 days).
Key findings
- Surgical revascularization led to -127.8 days with MALE or death in non-CKD patients.
- In mild-moderate CKD, the RMTL difference was -63.2 days.
- No significant benefit was observed in advanced CKD with a RMTL difference of -16.4 days.
- Mortality benefit from surgical revascularization diminished with more severe CKD.
Why it matters
Understanding the differential impact of revascularization strategies based on kidney function is crucial for optimizing treatment plans in patients with CLTI, particularly those with varying degrees of chronic kidney disease.