Elevated skin perfusion pressure 48 hours after endovascular therapy predicts early wound healing in chronic limb-threatening ischemia

Abstract

Background:

Adequate distal perfusion assessment is crucial for managing chronic limb-threatening ischemia (CLTI). Skin perfusion pressure (SPP) and transcutaneous oxygen pressure (TcPO₂) are commonly used to evaluate perfusion and predict wound healing. The main objective of this study was to compare the effectiveness of SPP and TcPO₂ in predicting early wound healing following endovascular therapy (EVT) for CLTI.

Methods:

We retrospectively reviewed 99 limbs from 87 patients with Rutherford category 5 or 6 CLTI enrolled in the K-VIS ELLA registry (ClinicalTrials.gov Identifier: NCT02748226). SPP and TcPO₂ were measured before and within 48 hours after EVT. Clinical outcomes included early wound healing (defined as complete epithelialization without major amputation within 3 months), major amputation, repeat revascularization, major adverse limb events (MALE), and all-cause death.

Results:

A high post-EVT SPP (⩾ 48 mmHg) significantly predicted early wound healing and was associated with a higher proportion of wound healing and a lower risk of repeat revascularization at 6 months. TcPO₂ did not significantly predict early wound healing; however, a high post-EVT TcPO₂ (⩾ 27 mmHg) correlated with lower proportions of repeat revascularization and MALE at 6 months. Neither SPP nor TcPO₂ was associated with mortality or major amputation.

Conclusion:

High SPP within 48 hours post-EVT was a significant predictor of early wound healing in CLTI. Although TcPO₂ was not predictive of early wound healing, it was linked to other favorable limb outcomes. Further studies are required to validate our findings and define the complementary roles of SPP and TcPO₂ in managing CLTI.