Assessing and treating lower extremity arterial disease


This year at the VEITHsymposium, lower extremity arterial disease diagnosis and treatment takes pride of place in multiple sessions on each day.

For example, Tuesday will feature a special afternoon program on Hot New Topics In Lower Extremity Occlusive Disease Treatment, and on Wednesday morning, an associate faculty session will be held on Progress In Lower Extremity Occlusive Disease And Its Treatments.

In one particular presentation on Wednesday morning, Arsalan Wafi, MBBS, a clinical researcher at St. George’s Vascular Institute, London, will present a 10-year prospective study demonstrating that the poor mobility, lack of statin use, and socioeconomic deprivation are all associated with worse survival after a major lower limb amputation. Dr. Wafi will discuss how he and his colleagues assessed consecutive 805 major lower limb amputation patients seen in the Roehampton Rehabilitation Center between January 2007 and January 2018, using prospective records, which included demographics, etiologies of limb loss, operative details, medications, and mortality data over a 10-year follow-up period.

A total of 611 (76%) occurred in men, and 194 (24%) in women. Etiologies included diabetes mellitus, peripheral vascular disease, and other causes such as trauma, malignancy, sepsis, and complex regional pain syndrome.

Dr. Wafi will present data showing that living in a deprived area and being further away from the rehabilitation center were both significantly associated with poorer survival. Diabetes mellitus or peripheral vascular disease were associated with significantly shorter survival, compared with other etiologies, and not being on a statin was associated with significantly worse survival among the vascular patients. In addition, poorer overall mobility at discharge from rehabilitation was associated with poorer survival, according to the researchers. However there was no significant difference in survival between below-knee and above-knee amputees, or between unilateral and bilateral amputees.

Thursday will be highlighted by a session on New Devices For Treating Lower Extremity Lesions By Endovascular Or Open Techniques, and Friday will see a session New Developments In The Treatment Of Popliteal Diseases And Aneurysms.

This is only one of many such studies focused on lower extremity arterial disease at this year’s VEITHsymposium.