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Innovations (Phila) ; 17(5): 392-400, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36226666

RESUMEN

OBJECTIVE: This subgroup analysis aimed to evaluate the effect of comorbidities on infrapopliteal angioplasty outcomes in patients with chronic limb-threatening ischemia (CLTI). METHODS: This was an observational study evaluating eligible CLTI patients aged >18 years who underwent infrapopliteal angioplasty between April 2014 and May 2017 at a tertiary care center. Subgroup analyses were based on (1) baseline glycated hemoglobin (HbA1c ≤6.5% vs >6.5%), (2) presence/absence of chronic kidney disease (CKD), and (3) control of lipid parameters. RESULTS: A total of 231 patients with 332 infrapopliteal vessels were treated. While diabetes was prevalent in all participants, hypertension, coronary artery disease, and CKD were reported in 76.6%, 46.3%, and 25.5% of patients at baseline, respectively. The overall technical success rate was 84.4%, and the patency rate at 6 months was 82.04%. Patency at 6 months, wound healing, in-line flow, and complete plantar arch formation were numerically higher in patients with HbA1c ≤6.5% versus >6.5%, but all comparisons were nonsignificant. According to multivariable analysis, the odds of wounds not healing was 2.38 times higher (odds ratio [OR] = 2.4, 95% confidence interval [CI]: 1.2 to 4.5) and developing plantar arch was 5.88 times higher (OR = 5.9, 95% CI: 1.3 to 25) among patients with CKD compared with patients without CKD. CONCLUSIONS: The 6-month outcomes of infrapopliteal angioplasty may be better in patients with controlled versus uncontrolled glycemic levels. Control of lipid parameters may not have a significant influence on outcomes, especially in patients on statin therapy. The short-term outcomes may be similar in patients with and without CKD.


Asunto(s)
Enfermedad Arterial Periférica , Insuficiencia Renal Crónica , Humanos , Arteria Poplítea/cirugía , Enfermedad Arterial Periférica/complicaciones , Enfermedad Arterial Periférica/epidemiología , Enfermedad Arterial Periférica/terapia , Recuperación del Miembro , Isquemia/epidemiología , Isquemia/terapia , Isquemia/etiología , Isquemia Crónica que Amenaza las Extremidades , Amputación Quirúrgica , Hemoglobina Glucada , Grado de Desobstrucción Vascular , Estudios Retrospectivos , Resultado del Tratamiento , Angioplastia , Factores de Riesgo , Insuficiencia Renal Crónica/etiología , Lípidos
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