Clinical Characteristics and Angioplasty Outcomes in Lower Extremity Artery Disease Patients with Normal Ankle-Brachial Index: A Clinical Conundrum.

IF 1.8 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta Cardiologica Sinica Pub Date : 2025-09-01 DOI:10.6515/ACS.202509_41(5).20250515A

Yi-Jia Su, Szu-Han Wang, Po-Wei Chen, Ting-Hsing Chao, Hsien-Yuan Chang

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引用次数: 0

Abstract

Background: The resting ankle-brachial index (ABI) is widely used to diagnose lower extremity artery disease (LEAD). However, some LEAD patients have a normal ABI yet require percutaneous transluminal angioplasty (PTA).

Methods: This was a retrospective study of consecutive LEAD patients who underwent PTA. The patients were classified into two groups based on the ABI of the limb that underwent PTA: the ABI-normal group (ABI 0.91-1.40), and ABI-abnormal group (ABI ≤ 0.90 or > 1.40). The primary endpoints were major adverse cardiovascular and cerebral events (MACCEs) and major adverse limb events (MALEs).

Results: Of the 334 patients (mean age: 70 ± 12 years, 60% male), 69 (21%) had a normal ABI, and 265 (79%) had an abnormal ABI. After a median follow-up of 1.5 (0.6-3.1) years, 84 (25%) patients reached the primary or secondary endpoints. The ABI-normal group had a higher proportion of males (73% vs. 57%, p = 0.02) and a higher prevalence of chronic kidney disease (78% vs. 56%, p < 0.01). Angiography revealed less severe lesions in the femoropopliteal artery (p < 0.01) and a lower rate of stent deployment (15% vs. 31%, p < 0.01) in the ABI-normal group than in the ABI-abnormal group. However, the incidence rates of MACCEs (29% vs. 24%, p = 0.56) and MALEs (23% vs. 28%, p = 0.63) were comparable in the two groups.

Conclusions: LEAD patients with a normal ABI often have less severe above-the-knee artery lesions but similar poor outcomes, highlighting the need for additional hemodynamic assessments and increased clinical attention.

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正常踝肱指数的下肢动脉疾病患者的临床特征和血管成形术结果：一个临床难题。

背景：静息踝肱指数（ABI）被广泛用于诊断下肢动脉疾病（LEAD）。然而，一些铅患者ABI正常，但需要经皮腔内血管成形术（PTA）。方法：对连续接受PTA治疗的LEAD患者进行回顾性研究。根据行PTA肢体的ABI分为两组：ABI正常组（ABI 0.91-1.40）和ABI异常组（ABI≤0.90或≥1.40）。主要终点是主要的心血管和大脑不良事件（MACCEs）和主要的肢体不良事件（男性）。结果：334例患者（平均年龄70±12岁，男性占60%），69例（21%）ABI正常，265例（79%）ABI异常。在中位随访1.5年（0.6-3.1年）后，84例（25%）患者达到了主要或次要终点。abi正常组男性比例较高（73%对57%，p = 0.02），慢性肾脏疾病患病率较高（78%对56%，p < 0.01）。血管造影显示，与abi异常组相比，abi正常组股腘动脉病变较轻（p < 0.01），支架置入率较低（15% vs. 31%, p < 0.01）。然而，两组的MACCEs发生率（29%对24%，p = 0.56）和男性发生率（23%对28%，p = 0.63）具有可比性。结论：ABI正常的铅患者通常有较轻的膝上动脉病变，但类似的不良结局，强调需要额外的血流动力学评估和增加临床关注。

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

Acta Cardiologica Sinica 医学-心血管系统

CiteScore

2.90

自引率

15.80%

发文量

144

审稿时长

>12 weeks

期刊介绍： Acta Cardiologica Sinica welcomes all the papers in the fields related to cardiovascular medicine including basic research, vascular biology, clinical pharmacology, clinical trial, critical care medicine, coronary artery disease, interventional cardiology, arrythmia and electrophysiology, atherosclerosis, hypertension, cardiomyopathy and heart failure, valvular and structure cardiac disease, pediatric cardiology, cardiovascular surgery, and so on. We received papers from more than 20 countries and areas of the world. Currently, 40% of the papers were submitted to Acta Cardiologica Sinica from Taiwan, 20% from China, and 20% from the other countries and areas in the world. The acceptance rate for publication was around 50% in general.