Factors effecting the success of retrograde tibiopedal access and recanalization in infrapopliteal artery occlusions.

IF 1.4 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Diagnostic and interventional radiology Pub Date : 2024-09-09 DOI:10.4274/dir.2024.242833

Cemal Aydın Gündoğmuş, Hande Özen Atalay, Vugar Samadli, Levent Oğuzkurt

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引用次数: 0

Abstract

Purpose: Peripheral arterial disease (PAD) is increasingly prevalent, particularly among the aging population. Retrograde tibiopedal access (RTPA) has emerged as a useful endovascular treatment for PAD. However, there is limited research examining factors that influence the efficacy of RTPA. To investigate factors affecting the access, crossing, and recanalization success rates of RTPA for infrapopliteal PAD treatment.

Methods: A retrospective study was conducted on 720 patients who underwent endovascular treatment for PAD. Of these, 104 patients (mean age: 65.5 ± 16.2; 89 men) with 131 RTPA trials were included in the final evaluation. The disease and its duration, Rutherford score, smoking status, access site, and its occlusion status, access, crossing, and recanalization success were noted. Data were analyzed using Pearson's chi-square and Mann-Whitney U tests and multivariate logistic regression to evaluate the impact of various factors on success rates.

Results: The access success rate was 82.6%, the crossing success rate was 95.4%, and the recanalization success rate was 74%. Access success was significantly higher when the dorsal pedal artery (DPA) was the access artery compared with the posterior tibial artery (91.3% vs. 74.2%, P = 0.009). Access success was notably lower in patients with thromboangiitis obliterans compared with patients with diabetes mellitus (DM) and non-DM atherosclerosis (68.6% vs. 90.3% and 80.3%, P = 0.019). Recanalization success was higher when the puncture site was non-occluded (76.7% vs. 53.5%, P = 0.023).

Conclusion: The study suggests that RTPA is a generally effective and safe technique for infrapopliteal PAD treatment. The most favorable outcomes are observed in individuals with DM who have a non-occluded DPA at the puncture site. Recanalization success is only affected by the patency of the artery at the puncture site.

Clinical significance: These findings offer targeted guidance for clinicians and highlight areas requiring further investigation.

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影响胫骨下动脉闭塞逆行入路和再通成功的因素。

目的：外周动脉疾病（PAD）越来越普遍，尤其是在老龄人口中。胫骨后入路（RTPA）已成为治疗 PAD 的一种有效的血管内治疗方法。然而，目前对影响 RTPA 疗效因素的研究还很有限。目的：研究影响 RTPA 治疗胫骨下 PAD 的入路、交叉和再闭塞成功率的因素：方法：对 720 名接受血管内治疗的 PAD 患者进行了回顾性研究。其中，104 名患者（平均年龄：65.5 ± 16.2；89 名男性）接受了 131 次 RTPA 试验，并纳入最终评估。研究人员注意到了患者的疾病及其持续时间、卢瑟福评分、吸烟状况、通路部位及其闭塞状况、通路、交叉和再通路的成功率。采用皮尔逊卡方检验、曼-惠特尼U检验和多变量逻辑回归分析数据，以评估各种因素对成功率的影响：入路成功率为 82.6%，穿刺成功率为 95.4%，再狭窄成功率为 74%。与胫后动脉相比，以足背动脉（DPA）为入路动脉的入路成功率明显更高（91.3% 对 74.2%，P = 0.009）。与糖尿病（DM）和非糖尿病动脉粥样硬化患者相比，血栓闭塞性脉管炎患者的入路成功率明显较低（68.6% 对 90.3% 和 80.3%，P = 0.019）。穿刺部位未闭塞时，再通成功率更高（76.7% vs. 53.5%，P = 0.023）：研究表明，RTPA 是治疗腘窝下 PAD 的一种普遍有效且安全的技术。研究结果表明，RTPA 是治疗腘下动脉供血不足的一种普遍有效且安全的技术。患有糖尿病且穿刺部位的 DPA 未闭塞者的疗效最佳。再通成功率仅受穿刺部位动脉是否通畅的影响：这些发现为临床医生提供了有针对性的指导，并强调了需要进一步研究的领域。

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

Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging

自引率

4.80%

发文量

期刊介绍： Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.