Medial Arterial Calcification Score Predicts Wound Healing and Major Amputation in Patients with Chronic Limb-Threatening Ischemia and Inframalleolar Lesions Undergoing Endovascular Therapy: Results from the MAVERICK Study

PURPOSE: To identify prognostic factors for wound healing and major amputation in patients with chronic limb-threatening ischemia (CLTI) and inframalleolar lesions undergoing endovascular therapy (EVT). MATERIALS AND METHODS: We conducted a multicenter, retrospective observational study involving 401 limbs in 318 patients with Rutherford classification 5 to 6 and inframalleolar disease treated with EVT between January 2018 and August 2022. The primary endpoint was 6-month wound healing, and the secondary endpoint was 1-year freedom from major amputation. We used the Cox proportional hazards models to identify independent predictors. RESULTS: The 6-month wound healing rate was 48.2%, and the 1-year freedom from major amputation was 87.9%. Rutherford classification 6 (hazard ratio [HR]=0.69; 95% confidence interval [CI]=0.50-0.95; p=0.022) and each 1-point increase in the medial arterial calcification (MAC) score (HR=0.84; 95% CI=0.77-0.93; p