Endovascular Revascularization and Outcomes of Critical Limb-Threatening Ischemia in Trinidad and Tobago: The EVENT Pilot Study-Challenges in a Limited-Resource, Caribbean Setting.
IF 3
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
引用次数: 0
Abstract
Introduction: This retrospective study investigated major adverse limb events (MALE) and mortality outcomes in critical limb-threatening ischemia (CLTI) patients with tissue loss after an endovascular revascularization-first (EVR-1st) strategy.
Methods: MALE and mortality were assessed in 157 consecutive patients with CLTI and tissue loss from June 2019 to June 2022 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago.
Results: 157 patients underwent the EVR-1st strategy, of whom 20 were pivoted to immediate surgical revascularization (SR). Of the remaining 137 patients, successful EVR was achieved in 112, giving a procedural success of 82% and an all-comer overall success of 71%. The mortality and MALE rates were 2.7% and 8.9% at 2 years, respectively. Males and patients with previous major amputations were at significantly higher risk for MALE (p values of 0.016 and 0.018, respectively). There was a statistically significant difference in successful EVR for both Rutherford-Baker (RB) 5 (minor) and RB 6 (major) classifications: 63 (56%) vs. 5 (20%) and 49 (44%) vs. 20 (80%), both with a p value of 0.01. There were no differences in successful EVR amongst Wound, Ischemia, Foot Infection (WIfI) clinical stages. There were no differences in successful EVR amongst the Trans-Atlantic Inter-Society Consensus (TASC II) classifications.
Conclusions: This study may prove clinically informative and applicable for an EVR-1st management strategy for high-risk patients with CLTI in a limited-resource, Caribbean setting.
Trial registration number: NCT05547022 (retrospectively registered).
特立尼达和多巴哥严重肢体缺血的血管内血管重建和结果:EVENT试点研究-在资源有限的加勒比地区的挑战。
简介:本回顾性研究调查了在血管内血管重建术(evr -1)策略后组织丢失的严重肢体威胁性缺血(CLTI)患者的主要肢体不良事件(MALE)和死亡率结果。方法:对特立尼达和多巴哥埃里克·威廉姆斯医学科学中心2019年6月至2022年6月期间连续157例CLTI和组织丢失患者的男性和死亡率进行评估。结果:157例患者采用evr -1策略，其中20例患者立即进行外科血运重建术(SR)。在其余137例患者中，112例成功实现EVR，手术成功率为82%，所有患者的总体成功率为71%。2年时死亡率和男性死亡率分别为2.7%和8.9%。男性和既往大截肢患者发生MALE的风险显著高于男性(p值分别为0.016和0.018)。Rutherford-Baker (RB) 5(次要)和RB 6(主要)分类成功EVR的差异有统计学意义:63(56%)比5(20%)，49(44%)比20 (80%)，p值均为0.01。伤口、缺血、足部感染(WIfI)临床分期EVR成功率无差异。在跨大西洋社会共识(TASC II)分类中，成功的EVR没有差异。结论:在资源有限的加勒比地区，这项研究可能证明具有临床信息，并适用于evr -1型CLTI高危患者的管理策略。试验注册号:NCT05547022(回顾性注册)。
本文章由计算机程序翻译，如有差异，请以英文原文为准。
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来源期刊
Cardiology and Therapy
CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.30
自引率
0.00%
发文量
38
审稿时长
6 weeks
期刊介绍：
Aims and Scope
Cardiology and Therapy is an international, open access, peer reviewed (single-blind), rapid-publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of cardiovascular therapies and interventions, including devices. Studies relating to diagnosis and diagnostics, pharmacoeconomics, public health, quality of life, as well as patient care, management and education are also encouraged.
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