Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing.
Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing.
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伤口红晕的获得是伤口愈合最重要的血管造影终点。
DOI：
10.1016/j.jcin.2016.10.026
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Masato Nakamura
中科院分区：
文献类型：
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作者：
M. Utsunomiya;M. Takahara;O. Iida;Yasutaka Yamauchi;D. Kawasaki;Y. Yokoi;Y. Soga;N. Ohura;Masato Nakamura
本研究旨在评价血管内治疗(EVT)治疗创面愈合的最佳血管造影终点。背景多篇报道显示，严重肢体缺血(CLI)的血管内介入治疗后，通畅率和保肢率均可接受。然而，EVT的最佳血管造影终点仍不清楚。方法我们对未来多中心OIVE(严重肢体缺血患者腹股沟下血管的血管内治疗)登记调查进行了亚分析，评估了接受腹股沟下EVT治疗CLI的患者。我们分析了185条肢体缺血性溃疡的数据，这些肢体被归类为卢瑟福5级或6级，仅接受EVT治疗(即，未接受搭桥手术)。采用Kaplan-Meier法评价EVT后创面愈合率。使用COX比例风险模型评估最终血管造影数据与伤口愈合之间的关系。有创面红晕的患者创面愈合的概率显著高于无创面红晕的患者(79.6%vs.46.5%；P=0.01)。在多因素分析中，伤口红晕的获得是伤口愈合的独立预测因素。结论EVT后伤口红晕的出现与伤口愈合显著相关。创面潮红可作为EVT的血管造影终点，可作为CLI患者伤口愈合的新的预测指标。
ObjectivesThis study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing.BackgroundSeveral reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear.MethodsWe conducted a subanalysis of the prospective multicenter OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia) registry investigation assessing patients who received infrainguinal EVT for CLI. We analyzed data from 185 limbs with ischemic ulcerations classified as Rutherford class 5 or 6, managed with EVT alone (i.e., not undergoing bypass surgery). The wound healing rate after EVT was estimated by the Kaplan-Meier method. The association between final angiographic data and wound healing was assessed employing a Cox proportional hazards model.ResultsThe overall wound healing rate was 73.5%. The probabilities of wound healing in patients with wound blush obtainment was significantly higher than that of those without wound blush (79.6% vs. 46.5%; p = 0.01). In the multivariate analysis, wound blush obtainment was an independent predictor of wound healing.ConclusionThe presence of wound blush after EVT is significantly associated with wound healing. Wound blush as an angiographic endpoint for EVT may serve as a novel predictor of wound healing in patients with CLI.