Endovascular Revascularization Failure in African American Patients: Developing a Predictive Model

Peripheral artery disease (PAD) is a chronic condition that causes blockages in arteries, resulting in lack of blood flow to the legs. One common treatment method is endovascular revascularization, which is the threading of a small tube into the artery to remove or flatten the blockages. African Americans are more likely to be diagnosed with PAD; however, they are less likely to have successful endovascular revascularization procedures.

This study looked at African American patients who had successful endovascular revascularization and those who did not in order to determine what was different between the two groups. These differences were then used to create a model to predict who would not have successful endovascular revascularization within 30 days and within 1 year. Another model was built to predict unsuccessful endovascular revascularization within one year using a machine learning technique called Random Forest.

My results showed that symptoms were most helpful in predicting unsuccessful endovascular revascularization. Patients who had pain in their legs when resting and wounds on their skin due to lack of blood flow were most likely to have unsuccessful endovascular revascularization at both 30 days and 1 year. Additionally, the location of the blockage in the artery helped predict the outcome, with blockages in the upper leg being most likely to be unsuccessfully revascularized. This information can be used to improve when the endovascular revascularization is performed and decide what follow-up needs to happen afterwards. This could help improve outcomes for African American patients with PAD.