# Impact of Dementia on the Outcome of Surgical Revascularization for Chronic Limb-Threatening Ischemia

## TL;DR

This study finds that dementia worsens outcomes after surgery for a severe leg blood flow condition, but surgery can still save limbs without major complications.

## Contribution

The study identifies dementia severity as a predictor of poor surgical outcomes in CLTI patients.

## Key findings

- High-grade dementia patients had significantly lower amputation-free survival after surgery.
- No significant differences were found in limb salvage or complication rates between dementia groups.
- Surgical revascularization remains a viable option for limb salvage despite dementia.

## Abstract

Objectives: Dementia and chronic limb-threatening ischemia (CLTI) are independent risk factors for a poor life prognosis. We investigated the long-term results of surgical revascularization for CLTI complicated by dementia.

Methods: The clinical records of 174 consecutive patients with CLTI and 205 revascularized limbs were prospectively collected from a database. According to the criteria for dementia, the patients were divided into a low-grade dementia group (L group, n = 152) and a high-grade dementia group (H group, n = 22), and the long-term results after surgery were retrospectively analyzed.

Results: The 2-year amputation-free survival (AFS) after surgery was significantly lower in the H group than in the L group (L group, 82.3%; H group, 39.3%; p <0.001). However, no marked differences were observed between the dementia groups regarding the freedom from major adverse limb event (MALE) (L group, 86.6%; H group, 83.1%; p = 0.103), freedom from major adverse cardiovascular event (MACE) (L group, 75.6%; H group, 71.3%; p = 0.685), and limb salvage (L group, 75.6%; H, group 71.3%; p = 0.685) after surgery.

Conclusions: Dementia may be a predictor of a poor prognosis after surgery for CLTI. However, surgical revascularization may lead to limb salvage without serious postoperative complications. Therefore, surgical revascularization may be a useful treatment option if the patient or family requires such treatment.