The Incidence of Chronic Limb-Threatening Ischemia in the Midland Region of New Zealand over a 12-Year Period

Abstract

The epidemiology of severe PAD, as characterized by short-distance intermittent claudication (IC) and chronic limb-threatening ischemia (CLTI), remains undefined in New Zealand (NZ). This was a retrospective observational cohort study of the Midland region in NZ, including all lower limb PAD-related surgical and percutaneous interventions between the 1st of January 2010 and the 31st of December 2021. Overall, 2541 patients were included. The mean annual incidence of short-distance IC was 15.8 per 100,000, and of CLTI was 36.2 per 100,000 population. The annual incidence of both conditions was greater in men. Women presented 3 years older with PAD (p < 0.001). Patients with short-distance IC had lower ipsilateral major limb amputation at 30 days compared to CLTI (IC 2, 0.3% vs. CLTI 298, 16.7%, p < 0.001). The 30-day mortality was greater in elderly patients (<65 years 2.7% vs. ≥65 years 4.4%, p = 0.049), but did not differ depending on sex (females 36, 3.7% vs. males 64, 4.1%, p = 0.787). Elderly age was associated with a worse survival for both short-distance IC and CLTI. There was a worse survival for females with CLTI. In conclusion, PAD imposes a significant burden in NZ, and further research is required in order to reduce this disparity.

The use of fetal bovine acellular dermal matrix in severe diabetic foot ulceration and threatened limbs with tissue loss the use of FBADM as an adjunct for complex wounds

“…Some patients were not offered this treatment as they were unable to travel long distances and therefore it was not possible to follow patients up at regular intervals. 21 Thus, this study cannot prove superiority of FBADM over standard wound management in patients with severe ulceration; however, it does provide a basis for future studies focused on this cohort. Future studies could aim to recruit a greater number of patients, and to provide a comparison via observation of a control group of patients with severe foot ulceration that receive standard wound care.…”

Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry

“…Colleagues from Auckland and Hamilton analyzed 1773 patients with CLTI in the midland region of New Zealand over a 12 year period. They found a worse long-term survival rate for women with CLTI, despite 30 day mortality not differing depending on sex [ 23 ].…”

The prescribing of cardioprotective medications and the impact on survival for patients with peripheral artery disease that undergo intervention

“…Reporting of this observational study has followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines 13 . The methodology, criteria for inclusion and exclusion, and comorbidity definitions has previously been defined 1 . In brief, this was a retrospective observational study of patients in the Midland region of NZ that underwent percutaneous and surgical intervention for lower limb PAD at a tertiary referral centre (Waikato Hospital, NZ) between 1st of January 2010 and 31st of December 2021.…”

“…Lower limb peripheral arterial disease (PAD) conveys a large health burden in Aotearoa New Zealand (NZ). 1 PAD is a marker of generalized atherosclerotic disease, and thus patients are at higher risk of major adverse cardiovascular events (MACE) and increased risk of early mortality. 2,3 Prompt and aggressive secondary prevention with medical therapy may improve cardiovascular related outcomes for patients with PAD.…”