Association of systemic inflammatory indices with lesion localization and revascularization outcomes in peripheral artery disease

Systemic inflammation plays a key role in peripheral artery disease (PAD) pathophysiology and may influence revascularization outcomes. This study aimed to compare inflammatory indices between patients with isolated superficial femoral artery (SFA) and below-the-knee (BTK) lesions and to evaluate their association with revascularization success. A total of 90 patients who underwent successful endovascular treatment between January 2023 and May 2025 were retrospectively analyzed. Patients were divided into two groups: isolated SFA (Group 1) and isolated BTK (Group 2) lesions. Inflammatory indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were calculated. Lesions were classified using TransAtlantic Inter-Society Consensus II (TASC II) and Global Limb Anatomic Staging System (GLASS) systems. Correlations between revascularization success and inflammatory indices were assessed through Spearman and multivariable regression analyses. Group 2 (BTK) had significantly higher NLR, SII, and SIRI values compared to Group 1 (p<0.05). Revascularization success showed significant negative correlations with elevated inflammatory indices. GLASS stage, NLR, and presence of diabetes emerged as independent predictors of procedural outcome (p<0.05). The inflammatory burden in PAD varies by anatomical location, with BTK lesions exhibiting greater systemic inflammation. Inflammatory indices may serve as prognostic tools in predicting endovascular treatment outcomes.