Clinical profile, anatomical variations, and short-term clinical outcomes in patients with chronic lower limb ischemia
Abstract
Background
Peripheral artery disease is a critical manifestation of systemic atherosclerosis, yet clinical data regarding its anatomical patterns and short-term prognosis within the Indian subcontinent remain limited. Understanding these variations is essential for optimizing secondary prevention and intervention strategies. This study aimed to characterize the clinical profile, anatomical disease patterns, and three-month outcomes of patients with newly diagnosed lower extremity peripheral artery disease in a specialized Indian tertiary care setting.
Methods
We conducted a prospective, hospital-based observational study of 400 consecutive patients with newly diagnosed infrarenal peripheral artery disease and symptoms for more than 14 days at a major cardiology research center in Western India. Subjects were followed for 3 months to evaluate all-cause mortality, major adverse cardiovascular events (MACE), and revascularization requirements.
Results
The cohort showed a marked male predominance (88.0%). Advanced presentations were common; 70.6% of patients were classified in Rutherford categories Three and Five. Anatomically, the femoropopliteal segment was the most affected (70.3%), and 54.7% of angiographically staged cases demonstrated complex TASC II category D lesions. At three months, all-cause mortality was 13.8%. Multivariable analysis identified serum creatinine (OR: 2.260, p=0.016), C-reactive protein (OR: 1.012, p<0.001), and established CAD (OR: 4.667, p<0.001) as independent predictors of mortality, while gangrene at presentation was the most potent predictor of amputation (OR: 52.75, p < 0.001).
Conclusion
Patients with peripheral artery disease in this setting present with high anatomical complexity and face significant short-term risks of mortality and revascularization. Aggressive management of metabolic, renal, and cardiac factors may be associated with improved survival in this high-risk population. These findings are limited to early (three-month) outcomes and should not be extrapolated to longer-term prognosis.
© 2026 Mit Chaudhari, Hasit Joshi, Pooja Vyas, Yaqub Sidatar, Khamir Banker, published by Romanian Society of Cardiology
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