Effect of balloon angioplasty on inframalleolar stenosis in patients with chronic limb-threatening ischemia.

IF 3.3 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Vascular Medicine Pub Date : 2025-08-13 DOI:10.1177/1358863X251361386

Riho Suzuki, Shuko Iwata, Yuichiro Hosoi, Yuki Tanaka, Michinao Tan, Katsumi Horiuchi, Yutaka Dannoura, Takao Makino, Hisashi Yokoshiki

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引用次数: 0

Abstract

Background: Although there are reports on angioplasty for inframalleolar (IM) occluded lesions in chronic limb-threatening ischemia (CLTI), the clinical outcomes specific to the IM stenotic lesions remain unclear. This study evaluated the effect of balloon angioplasty for IM stenotic lesions on the clinical outcomes of patients with CLTI.

Methods: This is a multicenter, retrospective, nonrandomized observational study. We retrospectively analyzed 194 patients with CLTI who underwent endovascular therapy for infrapopliteal (IP) lesions with IM stenotic lesions distal to the target IP lesion between November 2017 and August 2022. Angioplasty for IM stenotic lesions was performed in 99 patients. Outcome measures included wound healing rate, amputation-free survival (AFS), and freedom from reintervention. Propensity score matching was conducted to reduce baseline differences.

Results: Propensity score matching extracted 69 pairs with no significant baseline differences. The wound healing rate was not significantly different between the angioplasty and nonangioplasty groups (64.0% vs 59.6%, p = 0.94). Similarly, no significant differences were observed in AFS (82.4% vs 82.2%, p = 0.94) and freedom from reintervention (51.1% vs 46.6%, p = 0.81). However, the lesion morphology at reintervention progressed from stenosis to occlusion more frequently in the angioplasty group than in the nonangioplasty group (39.3% vs 12.9%, p = 0.035). Multivariate analysis identified angioplasty in IM lesions as an independent predictor of lesion morphology progression in IM lesions.

Conclusion: Angioplasty was associated with a higher rate of lesion morphology progression, which should be considered when determining treatment strategies.

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球囊血管成形术治疗慢性肢体缺血患者踝下狭窄的疗效。

背景：尽管有关于慢性肢体威胁缺血（CLTI）患者踝下（IM）闭塞病变血管成形术的报道，但针对踝下狭窄病变的临床结果尚不清楚。本研究评估了球囊血管成形术治疗IM狭窄病变对CLTI患者临床预后的影响。方法：这是一项多中心、回顾性、非随机观察性研究。我们回顾性分析了2017年11月至2022年8月期间接受血管内治疗的194例CLTI患者，这些患者的腘窝下（IP）病变伴目标IP病变远端IM狭窄病变。血管成形术治疗IM狭窄病变99例。结果测量包括伤口愈合率、无截肢生存（AFS）和免于再干预。进行倾向评分匹配以减少基线差异。结果：倾向评分匹配提取了69对无显著基线差异。血管成形术组与非血管成形术组的创面愈合率差异无统计学意义（64.0% vs 59.6%, p = 0.94）。同样，AFS （82.4% vs 82.2%, p = 0.94）和再干预自由度（51.1% vs 46.6%, p = 0.81）无显著差异。然而，与非血管成形术组相比，血管成形术组再介入时病变形态从狭窄发展到闭塞的频率更高（39.3% vs 12.9%, p = 0.035）。多变量分析表明，血管成形术是IM病变形态学进展的独立预测因子。结论：血管成形术与较高的病变形态学进展率相关，在确定治疗策略时应考虑到这一点。

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

Vascular Medicine 医学-外周血管病

CiteScore

5.70

自引率

5.70%

发文量

158

审稿时长

>12 weeks

期刊介绍： The premier, ISI-ranked journal of vascular medicine. Integrates the latest research in vascular biology with advancements for the practice of vascular medicine and vascular surgery. It features original research and reviews on vascular biology, epidemiology, diagnosis, medical treatment and interventions for vascular disease. A member of the Committee on Publication Ethics (COPE)