Peripheral Artery Disease in the Colombian Orinoquía: Epidemiologic Profile From a Resource-Limited Hemodynamics Unit

TL;DR

This study examines the epidemiology and outcomes of peripheral artery disease treatments in a resource-limited hospital in Colombia's Orinoquía region.

Contribution

The study provides a detailed epidemiological profile and clinical outcomes of PAD interventions in a resource-limited setting in Colombia.

Findings

PAD interventions had low complication and reintervention rates, suggesting safety of endovascular management.

Insulin-dependent diabetes and GLASS staging were significantly associated with limb amputation.

WIfI classification was strongly linked to procedural complications.

Abstract

Introduction:Peripheral artery disease (PAD) mainly compromises the lower limbs and may progress to chronic limb-threatening ischemia (CLTI); in this context, endovascular management has become a cornerstone of revascularization strategies. This study aimed to describe the epidemiologic, clinical, and procedural characteristics of patients with PAD treated in a Hemodynamics Unit in 2023 at a resource-limited hospital in Colombia.

Methods: We conducted a retrospective observational descriptive study at a regional referral hospital in the Orinoquía region of Colombia. All adults who underwent an endovascular procedure for PAD between January 1 and December 31, 2023, were included. Patient-level variables were analyzed for 115 patients, and procedure-level variables for 152 PAD-related interventions. Demographic, clinical, and procedural data were extracted from electronic medical records. Descriptive statistics were performed, and exploratory chi-square tests were used to evaluate associations between clinical classifications, comorbidities, procedural outcomes, and limb amputations. Data analysis was performed using RStudio, Version 2024.12.1 + 563 (Posit PBC, Boston, MA, USA).

Results: During the study period, 1,984 procedures were performed, of which 152 (7.7%) corresponded to PAD-related endovascular interventions in 115 patients. The majority of patients were male, comprising 68 (59.1%). The most common comorbidities were dyslipidemia in 93 (80.9%), hypertension in 84 (73.0%), and diabetes mellitus in 71 (61.7%) patients. Preoperative pharmacological treatment most frequently included antihypertensive therapy in 75 (65.2%) and high-intensity statins in 51 (44.25%) patients. CLTI was the main indication for intervention, documented in 89 (58.55%) cases. Complications of the procedures were found in 11 (7.24%) cases, and reinterventions were required in 23 (15.13%) cases. Among the observed statistical associations, clinically relevant findings included the association between insulin-dependent diabetes mellitus and limb amputation (χ² = 6.2805, p = 0.043), as well as the association between the Global Limb Anatomic Staging System (GLASS) and limb amputation (χ² = 30.078, p < 0.001). Another statistically significant association was observed between the Wound, Ischemia, foot Infection (WIfI) classification and procedural complications (χ² = 87.889, p < 0.001).

Conclusions: PAD interventions were associated with low complication and reintervention rates, supporting the safety of endovascular management for this type of disease. Clinical classification systems showed significant associations with limb amputation, highlighting the importance of baseline disease severity determination. Additionally, this study provides a relevant epidemiological profile of PAD management within this regional context.

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