Background

Pulse pressure (PP) is one of strong predictors of arterial stiffness and atherosclerosis. It has been reported that a 10 mmHg increase in PP increased the risk of major cardiovascular complications and mortality by nearly 20%. However, clinical significance of wide PP difference defined as PP ≥ 100mmHg following endovascular intervention (EVT) for patients with critical limb ischemia (CLI) are not clarified yet.

Methods

A total 286 consecutive patients with CLI for EVT from August 2004 to November 2012 were enrolled for this study. PP was calculated by subtracting the diastolic pressure from the systolic pressure of a brachial artery. A total 52 patients (18.2%) had PP ≥ 100mmHg. We compared the angiographic and clinical outcomes of patients with PP ≥ 100mmHg to those with PP < 100mmHg at 12-months.

Results

The baseline characteristics are well balanced between the two groups except Ankle brachial index which was lower in the PP ≥ 100mmHg group (Table 1). At 12 months, although the incidence of mortality, target lesion revascularization (TLR), target extremity revascularization (TER), and limb salvage rate were similar between the two groups, the patients who had PP ≥ 100mmHg had higher incidence of binary restenosis and showed lower primary patency and secondary patency than those who had PP <100mmHg (Table 2).

Conclusion

Higher PP was associated with lower ABI, higher restenosis rate and lower patency at 1 year, suggesting more intensive medical therapy with close clinical follow up will be required for patients with PP ≥ 100mmHg following EVT.

Copyright © 2014 Published by Elsevier Inc.