1 . 2019

Possibilities of using the WIfI classification system in patients with critical limb ischemia

Abstract

Background. The necessity of dividing a heterogeneous group of patients with critical limb ischemia IV stage according to the Fontaine-Pokrovsky classification into subgroups is substantiated for the purpose to predict the outcome and the selection of treatment strategy. The translation of the international WIfI classification system, created by the North American Society of Vascular Surgery (2014), was performed to determine the prognosis of limb loss and the benefit of revascu- larization.

The aim of the study: To determine the relationship between WIfI combinations and major amputation rate, amputation-free survival, total mortality at six months in no-option critical limb ischemia. Material and methods. We performed a retrospective, multicenter controlled trial (level of evidence II). 109 patients were included in the study. The patients were divided into 4 subgroups according to the WIfI combinations: 130 – 27% (n=29); 131 – 23% (n=25); 230 – 20% (n=22); 231 – 30% (n=33).

Results. Major amputation rate, amputation-free survival, total mortality in the natural course of disease with standard therapy were 29% (32), 64% (70) and 10% (11), respectively. By WIfI combinations, major amputation rate was: 130 – 14%; 131 – 24%; 230 – 27%; 231 – 48% (p=0,02); amputation free-survival was: 130 – 83%; 131 – 68%; 230 – 69%; 231 – 49% (p=0,04); total mortality was: 130 – 7%; 131 – 16%; 230 – 14%; 231 – 6% (p=0,51).

Conclusion. Amputation rate and amputation free-survival in the natural course of disease correlates with WIfI combinations. No significant differences were observed in total mortality.
WIfI classification system should help a wide range of specialists involved in the treatment of critical limb ischemia with ulcers in terms of predicting the risk of major amputation and the benefit of revascularization.

Keywords:no-option patients, natural course of disease, critical limb ischemia, WIfI classification system

For citation: Chervyakov Yu.V., Kha Kh.N., Gavrilenko A.V., Klimov A.E. Possibilities of using the WIfI classification system in patients with critical limb ischemia. Clin Experiment Surg. Petrovsky J. 2019; 7 (1): 54–61. doi: 10.24411/2308-1198- 2019-11007. (in Russian)
Received 18.09.2018. Accepted 06.02.2019.

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