Midterm outcomes and risk stratification after endovascular therapy for patients with critical limb ischaemia due to isolated below-the-knee lesions.
Eur J Vasc Endovasc Surg
; 43(3): 313-21, 2012 Mar.
Article
em En
| MEDLINE
| ID: mdl-22240338
ABSTRACT
OBJECTIVES:
To assess and risk stratify midterm clinical outcomes after endovascular therapy (EVT) by angioplasty only of patients with critical limb ischaemia (CLI) due to isolated below-the-knee (BTK) lesions.DESIGN:
Retrospective multicenter study. MATERIALS ANDMETHODS:
Between March 2004 and October 2010, 465 limbs (Rutherford 5 and 6 79%) from 406 patients were studied. Overall survival, limb salvage, and re-intervention were examined out to 3 years by the Kaplan-Meier method and the log-rank test. Their independent predictors and risk stratification were analysed.RESULTS:
Patient age was 71 ± 11 yrs, with 69% diabetics and 60% on dialysis. Mean follow-up was 18 ± 15 months. Overall survival was 76 ± 2 and 57 ± 4% at 1 and 3, years, respectively. Survival predictors were body mass index <18, non-ambulatory status and ejection fraction <45%. Two-year limb salvage rate was 80 ± 2%. Factors associated with major amputation were ulcers (Rutherford 6), diabetes mellitus, C-reactive protein>5 mg/dL, and age < 60 years. Two-year freedom from re-intervention was 66 ± 3%; age and below-the-ankle runoff number after angioplasty was negatively associated with re-intervention.CONCLUSIONS:
Despite relatively high mortality and re-intervention rates, limb salvage rate was acceptable after EVT for CLI patients with isolated BTK lesions. Risk stratification allows occurrence estimation for each end point.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Angioplastia com Balão
/
Salvamento de Membro
/
Isquemia
/
Perna (Membro)
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article