Asian journal of surgery · 2018
Factors affecting outcomes after endovascular treatment for femoropopliteal atherosclerotic lesions.
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Park Ui Jun, Kim Hyoung Tae, Roh Young-Nam
Аннотация
BACKGROUND/OBJECTIVE: This study aimed to investigate the outcomes of femoropopliteal interventions in relation to various influencing factors.
METHODS: A retrospective review of 243 endovascular procedures for femoropopliteal atherosclerotic lesions on 243 limbs of 197 patients was performed.
RESULTS: In patients with claudication, the TLR free rates at 1-, 3-, and 5-year intervals were 89.1%, 82.2%, and 78.9%, respectively. Amputation-free survival rates in the claudicants at 1-, 3-, and 5-year intervals were 95.3%, 81.1%, and 65.2%, respectively. Freedom from ischemia at 1-, 3-, and 5-year follow-ups was 77.8%, 69.0%, and 61.3%, respectively. In patients with critical limb ischemia, the TLR free rates at 1-, 3-, and 5-year intervals were 91.3%, 87.4%, and 65.4%, respectively, amputation free survival rates were 72.5%, 44.2%, and 36.8%, respectively, and their freedom from ischemia was 64.6%, 63.4%, and 49.7%, respectively. In the multivariate analysis of influencing factors related to freedom from ischemia, renal insufficiency (hazard ratio [HR] 1.623; 95% confidence interval [CI] 0.999-2.636; p = 0.050), TASC C/D lesion (HR 1.903; 95% CI 1.151-3.148; p = 0.012), and poor tibial runoff (HR 1.770; 95% CI 1.037-3.023; p = 0.036) were statistically significant risk factors. TASC C/D lesion and poor tibial runoff were significant risk factors for recurrent or persistent ischemia in claudication (p = 0.015) and in critical limb ischemia (p = 0.05), respectively.
CONCLUSION: Endovascular treatment for femoropopliteal atherosclerotic lesions showed acceptable intermediate-term and long-term outcomes. Renal insufficiency, TASC C/D lesions, and poor tibial runoff adversely affected freedom from ischemia.
METHODS: A retrospective review of 243 endovascular procedures for femoropopliteal atherosclerotic lesions on 243 limbs of 197 patients was performed.
RESULTS: In patients with claudication, the TLR free rates at 1-, 3-, and 5-year intervals were 89.1%, 82.2%, and 78.9%, respectively. Amputation-free survival rates in the claudicants at 1-, 3-, and 5-year intervals were 95.3%, 81.1%, and 65.2%, respectively. Freedom from ischemia at 1-, 3-, and 5-year follow-ups was 77.8%, 69.0%, and 61.3%, respectively. In patients with critical limb ischemia, the TLR free rates at 1-, 3-, and 5-year intervals were 91.3%, 87.4%, and 65.4%, respectively, amputation free survival rates were 72.5%, 44.2%, and 36.8%, respectively, and their freedom from ischemia was 64.6%, 63.4%, and 49.7%, respectively. In the multivariate analysis of influencing factors related to freedom from ischemia, renal insufficiency (hazard ratio [HR] 1.623; 95% confidence interval [CI] 0.999-2.636; p = 0.050), TASC C/D lesion (HR 1.903; 95% CI 1.151-3.148; p = 0.012), and poor tibial runoff (HR 1.770; 95% CI 1.037-3.023; p = 0.036) were statistically significant risk factors. TASC C/D lesion and poor tibial runoff were significant risk factors for recurrent or persistent ischemia in claudication (p = 0.015) and in critical limb ischemia (p = 0.05), respectively.
CONCLUSION: Endovascular treatment for femoropopliteal atherosclerotic lesions showed acceptable intermediate-term and long-term outcomes. Renal insufficiency, TASC C/D lesions, and poor tibial runoff adversely affected freedom from ischemia.