This study aimed to validate the correlation between the Global Limb Anatomical Staging System (GLASS) and limb-based patency (LBP) and angiosome-based target arterial path (TAP) and to detect the predictors of LBP loss. After the publication of the Global Vascular Guidelines in 2019, the evaluation of GLASS and identification of TAP have been recommended. However, there are few reports regarding GLASS. Eighty-three patients with chronic limb-threatening ischemia (CLTI) and tissue loss from 2016 to 2020 were evaluated. The correlation between GLASS and LBP and successful revascularization of angiosome-based TAP was analyzed. We also investigated the predictors of LBP loss. The number of patients in each GLASS stage was as follows: GLASS I, 6 patients; GLASS II, 15 patients; GLASS III, 62 patients. At 6 months, the Kaplan–Meier estimate of LBP was 66.7% in GLASS I, 41.6% in GLASS II, and 16.4% in GLASS III, respectively (p = 0.034). The rate of successful revascularization of angiosome-based TAP was 100% in GLASS I, 86.7% in GLASS II, and 46.8% in GLASS III, respectively (p = 0.002). Multivariate analysis showed that the Wound, Ischemia, and foot Infection (WIfI) stage [hazard ratio (HR) 1.58; 95% confidence interval (CI) 1.07–2.33; p = 0.021] and GLASS infrapopliteal (IP) grade (HR 1.96; 95% CI 1.31–2.95; p = 0.001) were the independent predictors of LBP loss. The GLASS stage was significantly correlated with successful revascularization of angiosome-based TAP and mid-term LBP. The WIfI stage and GLASS IP grade were the independent predictors of loss of LBP.

本研究旨在验证全球肢体解剖分期系统 (GLASS) 与基于肢体的通畅性 (LBP) 和基于血管体的靶动脉路径 (TAP) 之间的相关性，并检测 LBP 损失的预测因子。2019年全球血管指南发布后，建议对GLASS进行评估和TAP鉴定。然而，关于 GLASS 的报道很少。评估了 2016 年至 2020 年 83 名患有慢性肢体威胁性缺血 (CLTI) 和组织丢失的患者。分析了 GLASS 和 LBP 与基于血管体的 TAP 成功血运重建之间的相关性。我们还研究了 LBP 损失的预测因素。每个 GLASS 阶段的患者人数如下： GLASS I，6 例；GLASS II，15 名患者；GLASS III，62 名患者。6个月时，p  = 0.034）。基于血管小体的 TAP 的血运重建成功率分别在 GLASS I 中为 100%，在 GLASS II 中为 86.7%，在 GLASS III 中为 46.8%（p  = 0.002）。多变量分析表明，伤口、缺血和足部感染 (WIfI) 阶段 [风险比 (HR) 1.58; 95% 置信区间 (CI) 1.07–2.33；p  = 0.021] 和 GLASS 腘窝 (IP) 等级 (HR 1.96; 95% CI 1.31–2.95; p  = 0.001) 是 LBP 损失的独立预测因子。GLASS 阶段与基于血管体的 TAP 和中期 LBP 的成功血运重建显着相关。WIfI 分期和 GLASS IP 等级是 LBP 丧失的独立预测因子。