OPEN VS. ENDOVASCULAR REVASCULARIZATION IN CRITICAL LIMB ISCHEMIA: A COMPARATIVE ANALYSIS OF OUTCOMES AND PREDICTORS OF THERAPEUTIC FAILURE – A RETROSPECTIVE COHORT STUDY

Abstract

This article sought to compare clinical and limb salvage outcomes between open surgery and endovascular therapy in patients with peripheral arterial obstructive disease (PAOD), as well as to identify potential predictors of therapeutic failure. This was a single-center, retrospective cohort study that analyzed 140 patients with PAOD undergoing revascularization (open surgery n=24 vs. endovascular therapy n=116) between 2015 and 2025. Patients undergoing open revascularization therapy and endovascular therapy presented clinical and limb salvage outcomes with no statistically significant difference (p=0.374). Rates of MALE (p=0.377) and isolated major amputation (p=0.165) were also similar between groups. However, analysis of therapeutic failure predictors demonstrated that clinical severity of presentation, graded by the Rutherford scale (p<0.001), and the presence of Diabetes Mellitus (p=0.002), were the main prognostic factors, regardless of the technique employed. The findings suggest that the patient's clinical-metabolic profile (severity of ischemia and DM) was the crucial determinant for prognosis, more than the choice of surgical technique alone.