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Factors affecting patency of subintimal infrainguinal angioplasty in patients with critical lower limb ischemia.
- Source :
-
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery [Eur J Vasc Endovasc Surg] 2006 Dec; Vol. 32 (6), pp. 668-74. Date of Electronic Publication: 2006 Sep 11. - Publication Year :
- 2006
-
Abstract
- Background: Because subintimal angioplasty (SA) is a technique that can achieve recanalization of long arterial occlusions, it is considered an alternative to lower limb bypass operations. The aim of this prospective study was to identify the risk factors that affect patency of SA in patients suffering from critical limb ischemia (CLI).<br />Methods and Results: 51 consecutive infrainguinal SA were done in 46 patients suffered from CLI. The patients were followed-up with regular duplex scans up to 12 months post-intervention. Sex, atherosclerosis risk factors, and some technical details of the procedure (number of patent run-off vessels after the procedure, length and re-entry point of angioplasty) were examined as potential risk factors of patency, using survival analysis statistical techniques. The overall patency rate at 12 months post-intervention was 50%. According to Cox-regression analysis, the factors that affect patency were the number of run-off vessels and the length of occlusion. Patients with two or three run-off vessels had a hazard of occlusion of 0.30 (P = .027) compared to those who had one run-off vessel. The 12-months patency in patients with more than one run-off vessels was 81% vs. 25% in patients with one run-off vessel. Regarding the length of angioplasty, the hazard of reocclusion was 1.02 for every centimeter of occlusion (P = .049).<br />Conclusions: The number of patent run-off crural vessels after the angioplasty and the length of occlusion are significant risk factors for reocclusion of infrainguinal SA in patients with CLI. Trying to recanalize more than one run-off vessels could raise the SA patency.
- Subjects :
- Adult
Aged
Aged, 80 and over
Amputation, Surgical
Arterial Occlusive Diseases mortality
Arterial Occlusive Diseases physiopathology
Female
Femoral Artery surgery
Follow-Up Studies
Humans
Ischemia mortality
Kaplan-Meier Estimate
Limb Salvage
Male
Middle Aged
Popliteal Artery surgery
Prospective Studies
Regression Analysis
Reoperation
Risk Factors
Time Factors
Treatment Outcome
Tunica Intima surgery
Angioplasty methods
Arterial Occlusive Diseases surgery
Ischemia surgery
Lower Extremity blood supply
Vascular Patency
Subjects
Details
- Language :
- English
- ISSN :
- 1078-5884
- Volume :
- 32
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 16968668
- Full Text :
- https://doi.org/10.1016/j.ejvs.2006.07.016