Markers of Vascular Damage with Potential to Predict Amputation in Patients with Critical Limb Ischemia - Abstract
Critical limb ischemia (CLI) is the advanced presentation of peripheral arterial disease (PAD), characterized by persistent pain at rest and/or necrosis for more than two weeks. Endothelial dysfunction (ED) is considered a constant process during vascular damage. Aim: To explore the predictive ability of some markers of vascular damage in relation of lower limb amputation. Methods: We assessed the predictive ability of some biochemical (MDA, malondialdehyde and VEGF-A, Vascular Endothelial Growth Factor-alpha) determined from the femoral arterial circulation) and functional (FMD, flow mediated dilation) markers in relation with lower limb amputation during a follow-up of 30-days post-angioplasty in a population with CLI. Results: Significantly abnormal FMD pre-angioplasty values were associated with 67% of cases submitted to major amputation during the follow up period (p=0.03). MDA and VEGF-A reflected changes related with the endovascular procedure.