Clinical Outcomes of Patients With Cholesterol Crystal Embolism Accompanied by Lower Extremity Wound.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Angiology Pub Date : 2025-01-01 Epub Date: 2023-08-24 DOI:10.1177/00033197231195671

Yosuke Hata, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Naoko Higashino, Taku Toyoshima, Sho Nakao, Masashi Fukunaga, Daizo Kawasaki, Masahiko Fujihara, Mitsuyoshi Takahara, Toshiaki Mano

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引用次数: 0

Abstract

Cholesterol crystal embolism (CCE) accompanied by a lower extremity wound is occasionally difficult to differentiate from chronic limb-threatening ischemia (CLTI) and treat. The present multi-center retrospective observational study investigated the clinical characteristics and prognosis of CCE with lower extremity wounds. Consecutive patients (n = 58) clinically diagnosed as CCE with lower extremity wounds between April 2010 and December 2019 were studied. CCE was diagnosed using histological findings, foot condition, renal impairment, and eosinophilia. The primary outcome was 1-year wound healing rate. Patients with CCE were compared with 1309 patients diagnosed with CLTI with tissue loss during the same study period. The CCE group had a significantly more severe Wound, Ischemia, and foot Infection (WIfI) classification compared with the CLTI group. After Kaplan-Meier analysis, the CCE group had a similar 1-year wound healing (55.1 vs 58.3%, P = .096) as the CLTI group. In multivariate stratified Cox regression analysis by WIfI stages, CCE was significantly associated with poor wound healing compared with CLTI [hazard ratio .36 (95% confidence interval .21-.62)]. In conclusion, among the similar WIfI clinical stages, wound healing was significantly worse in the CCE group than in the CLTI group.

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胆固醇结晶栓塞并伴有下肢伤口患者的临床疗效。

伴有下肢伤口的胆固醇结晶栓塞（CCE）有时很难与危及肢体的慢性缺血（CLTI）区分开来并进行治疗。本项多中心回顾性观察研究调查了伴有下肢伤口的 CCE 的临床特征和预后。研究对象为2010年4月至2019年12月期间临床诊断为下肢伤口CCE的连续患者（n = 58）。CCE的诊断依据是组织学检查结果、足部状况、肾功能损害和嗜酸性粒细胞增多。主要结果是1年伤口愈合率。在同一研究期间，CCE患者与1309名被诊断为组织缺损的CLTI患者进行了比较。与CLTI组相比，CCE组的伤口、缺血和足部感染（WIfI）分级明显更严重。经过 Kaplan-Meier 分析，CCE 组的 1 年伤口愈合率（55.1% vs 58.3%，P = .096）与 CLTI 组相似。在按 WIfI 分期进行的多变量分层 Cox 回归分析中，与 CLTI 相比，CCE 与伤口愈合不良显著相关[危险比为 0.36（95% 置信区间为 0.21-0.62）]。总之，在相似的 WIfI 临床分期中，CCE 组的伤口愈合情况明显差于 CLTI 组。

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

Angiology 医学-外周血管病

CiteScore

5.50

自引率

14.30%

发文量

180

审稿时长

6-12 weeks

期刊介绍： A presentation of original, peer-reviewed original articles, review and case reports relative to all phases of all vascular diseases, Angiology (ANG) offers more than a typical cardiology journal. With approximately 1000 pages per year covering diagnostic methods, therapeutic approaches, and clinical and laboratory research, ANG is among the most informative publications in the field of peripheral vascular and cardiovascular diseases. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 13 days