慢性肢体缺血患者血运重建术后的临床结果。

IF 0.6 Q4 PERIPHERAL VASCULAR DISEASE
Annals of vascular diseases Pub Date : 2025-01-01 Epub Date: 2025-01-20 DOI:10.3400/avd.ra.24-00135
Akio Kodama
{"title":"慢性肢体缺血患者血运重建术后的临床结果。","authors":"Akio Kodama","doi":"10.3400/avd.ra.24-00135","DOIUrl":null,"url":null,"abstract":"<p><p>Chronic limb-threatening ischemia (CLTI) occurs in the advanced stage of peripheral artery disease and is associated with high risks of mortality and amputation. Universal management strategies are not always applicable, owing to population diversity, and the Western trials may not be applicable to Japanese patients, owing to differences in demographics and clinical profiles. This paper examines the outcomes of revascularization in Japanese CLTI patients and emphasizes the benefits of tailored management. Post-hoc analysis of the bypass versus angioplasty in severe ischemia of the leg (BASIL)-1 trial validated the use of the Global Limb Anatomic Staging System for predicting the outcomes of endovascular therapy (EVT) but not bypass surgery (BS). The SPINACH (surgical reconstruction versus peripheral intervention in patients with critical limb ischemia) registry revealed comparable 3-year amputation-free survival rates between patients who underwent EVT and those who underwent BS, with patient-specific factors such as limb status and general health influencing its success. Revascularization improved the quality of life, but benefits declined over time, especially in non-ambulatory and older patients on dialysis. Surgical reconstruction is better for preserving ambulation. Retrospective studies revealed pedal branch artery bypass as a viable option, functional independence as a predictor of survival, and zinc supplementation as promising for wound healing. Future research should focus on refining these strategies and exploring innovative approaches to overcome persistent challenges in CLTI care.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771150/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical Outcomes after Revascularization in Patients with Chronic Limb-Threatening Ischemia.\",\"authors\":\"Akio Kodama\",\"doi\":\"10.3400/avd.ra.24-00135\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Chronic limb-threatening ischemia (CLTI) occurs in the advanced stage of peripheral artery disease and is associated with high risks of mortality and amputation. Universal management strategies are not always applicable, owing to population diversity, and the Western trials may not be applicable to Japanese patients, owing to differences in demographics and clinical profiles. This paper examines the outcomes of revascularization in Japanese CLTI patients and emphasizes the benefits of tailored management. Post-hoc analysis of the bypass versus angioplasty in severe ischemia of the leg (BASIL)-1 trial validated the use of the Global Limb Anatomic Staging System for predicting the outcomes of endovascular therapy (EVT) but not bypass surgery (BS). The SPINACH (surgical reconstruction versus peripheral intervention in patients with critical limb ischemia) registry revealed comparable 3-year amputation-free survival rates between patients who underwent EVT and those who underwent BS, with patient-specific factors such as limb status and general health influencing its success. Revascularization improved the quality of life, but benefits declined over time, especially in non-ambulatory and older patients on dialysis. Surgical reconstruction is better for preserving ambulation. Retrospective studies revealed pedal branch artery bypass as a viable option, functional independence as a predictor of survival, and zinc supplementation as promising for wound healing. Future research should focus on refining these strategies and exploring innovative approaches to overcome persistent challenges in CLTI care.</p>\",\"PeriodicalId\":7995,\"journal\":{\"name\":\"Annals of vascular diseases\",\"volume\":\"18 1\",\"pages\":\"\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771150/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of vascular diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3400/avd.ra.24-00135\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3400/avd.ra.24-00135","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/20 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

摘要

慢性肢体威胁缺血(CLTI)发生在外周动脉疾病的晚期,与死亡率和截肢的高风险相关。由于人口多样性,普遍的管理策略并不总是适用,由于人口统计学和临床概况的差异,西方的试验可能不适用于日本患者。本文探讨了日本CLTI患者血运重建的结果,并强调了量身定制管理的好处。对腿部严重缺血的搭桥与血管成形术的事后分析(BASIL)-1试验验证了全球肢体解剖分期系统用于预测血管内治疗(EVT)而非搭桥手术(BS)的结果。菠菜(严重肢体缺血患者的手术重建与外周干预)登记显示,EVT患者和BS患者的3年无截肢生存率相当,患者的特定因素,如肢体状态和一般健康状况影响其成功。血运重建术改善了生活质量,但随着时间的推移,效益下降,特别是在非门诊和老年透析患者中。手术重建对保持活动能力较好。回顾性研究显示,脚支动脉旁路是一种可行的选择,功能独立性是生存的预测指标,补充锌对伤口愈合有希望。未来的研究应该集中在完善这些策略和探索创新的方法来克服CLTI护理的持续挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Outcomes after Revascularization in Patients with Chronic Limb-Threatening Ischemia.

Chronic limb-threatening ischemia (CLTI) occurs in the advanced stage of peripheral artery disease and is associated with high risks of mortality and amputation. Universal management strategies are not always applicable, owing to population diversity, and the Western trials may not be applicable to Japanese patients, owing to differences in demographics and clinical profiles. This paper examines the outcomes of revascularization in Japanese CLTI patients and emphasizes the benefits of tailored management. Post-hoc analysis of the bypass versus angioplasty in severe ischemia of the leg (BASIL)-1 trial validated the use of the Global Limb Anatomic Staging System for predicting the outcomes of endovascular therapy (EVT) but not bypass surgery (BS). The SPINACH (surgical reconstruction versus peripheral intervention in patients with critical limb ischemia) registry revealed comparable 3-year amputation-free survival rates between patients who underwent EVT and those who underwent BS, with patient-specific factors such as limb status and general health influencing its success. Revascularization improved the quality of life, but benefits declined over time, especially in non-ambulatory and older patients on dialysis. Surgical reconstruction is better for preserving ambulation. Retrospective studies revealed pedal branch artery bypass as a viable option, functional independence as a predictor of survival, and zinc supplementation as promising for wound healing. Future research should focus on refining these strategies and exploring innovative approaches to overcome persistent challenges in CLTI care.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Annals of vascular diseases
Annals of vascular diseases PERIPHERAL VASCULAR DISEASE-
自引率
0.00%
发文量
41
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信