Incidence of Angiographic Deterioration Following Inframalleolar Angioplasty and Its Impact on Outcomes in Patients With Chronic Limb-Threatening Ischemia Requiring Repeat Intervention.

Circulation reports Pub Date : 2024-10-18 eCollection Date: 2024-11-08 DOI:10.1253/circrep.CR-24-0103
Yosuke Hata, Osamu Iida, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Yasuhiro Matsuda, Hiroyuki Uematsu, Sho Nakao, Masaya Kusuda, Wataru Ariyasu, Toshiaki Mano
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Abstract

Background: Clinical impact of inframalleolar (IM) angioplasty in patients with chronic limb-threatening ischemia (CLTI) is still controversial.

Methods and results: This single-center, retrospective study included 168 patients with CLTI and tissue loss who underwent angioplasty for IM lesions. Angiographic follow up was performed at reintervention between April 2010 and December 2020. The outcome measure was the incidence of angiographic deterioration characterized by severe restenosis or occlusion of mildly stenotic lesions, occlusion of severely stenotic lesions, or extension of the occlusion length at reintervention. Angiographic deterioration was observed in 47.7% of patients, with the majority attributed to occlusion in severely stenotic lesions. Multivariate analysis revealed that a distal reference vessel diameter ≤1.0 mm in the initial angioplasty (hazard ratio 1.91 [95% confidence interval 1.20-3.04]; P=0.006) was significantly associated with angiographic deterioration of IM lesions at reintervention.

Conclusions: Angiographic deterioration occurred in approximately half of the patients with CLTI who underwent IM angioplasty and reintervention.

需要再次介入治疗的慢性肢体缺血患者接受无瓣膜血管成形术后血管造影恶化的发生率及其对疗效的影响
背景:对慢性肢体缺血(CLTI)患者进行踝下血管成形术的临床影响仍存在争议:这项单中心回顾性研究纳入了168例因IM病变接受血管成形术的CLTI和组织缺失患者。在2010年4月至2020年12月期间再次介入时进行了血管造影随访。研究结果的衡量标准是再介入时血管造影恶化的发生率,其特征为严重再狭窄或轻度狭窄病变闭塞、严重狭窄病变闭塞或闭塞长度延长。47.7%的患者出现血管造影恶化,其中大部分是由于严重狭窄病变闭塞所致。多变量分析显示,初次血管成形术的远端参考血管直径≤1.0 mm(危险比 1.91 [95% 置信区间 1.20-3.04];P=0.006)与再次介入时 IM 病变的血管造影恶化显著相关:结论:在接受IM血管成形术和再介入治疗的CLTI患者中,约半数患者的血管造影出现恶化。
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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