Clinical results of single-vessel versus multiple-vessel infrapopliteal intervention.
Clinical results of single-vessel versus multiple-vessel infrapopliteal intervention.
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单血管与多血管腘窝下介入治疗的临床结果。
DOI：
10.1016/j.jvs.2016.05.080
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发表时间：
2016
影响因子：
4.3
通讯作者：
Schermerhorn,MarcL
中科院分区：
文献类型：
--
作者：
Darling,JeremyD;McCallum,JohnC;Soden,PeterA;Hon,JohnJ;Guzman,RaulJ;Wyers,MarkC;Verhagen,HenceJ;Schermerhorn,MarcL
同时进行血管内介入治疗对多条膝下血管的影响尚不清楚，此类手术的短期和长期后遗症尚未报道。方法从2004年至2014年，528例患者的673条肢体因组织缺损（77%），静息痛（13%），既往治疗血管狭窄（5%），急性肢体缺血（3%）或跛行（2%）。结局包括伤口愈合、RAS事件（再次介入、大截肢或狭窄[多普勒递增> 3.5倍]）和死亡率。排除了没有严重肢体缺血（CLI）初始指征的患者。患者的特点是经历了一个单一的血管infropoplateal干预或多血管infropoplateal intervention.ResultsOf的673条肢体，558进行了成功的infropoplateal血管内介入CLI（86%的组织损失，14%的静息痛）。在单次手术中，503条肢体（90%）接受了单血管介入治疗，55条肢体（10%）接受了多血管介入治疗。接受单血管介入治疗的患者更常接受过同侧血管内手术（17% vs 6%;P= 0.03）或同侧旁路手术（20% vs 9%;P= 0.04）。Kaplan-Meier分析显示，229条肢体（49%）发生了1年内的RAS事件，1年内再次介入（22% vs 20%;P= 0.53）、大截肢（16% vs 10%;P= 0.24）或狭窄（29% vs 21%;P= 0.25）的发生率无显著差异。调整基线特征后，多变量回归分析表明，无论是大截肢率，也没有RAS事件之间的差异进行单血管与多血管介入（P= 0.26和P = 0.61，分别）。
ObjectiveThe effects of concomitant endovascular interventions on multiple infrapopliteal vessels are not well known, and the short-term and long-term sequelae of such procedures have not been reported.MethodsFrom 2004 to 2014, 673 limbs in 528 patients underwent an infrapopliteal endovascular intervention for tissue loss (77%), rest pain (13%), stenosis of a previously treated vessel (5%), acute limb ischemia (3%), or claudication (2%). Outcomes included wound healing, RAS events (reintervention, major amputation, or stenosis [>3.5x step-up by duplex]), and mortality. Patients without an initial indication of critical limb ischemia (CLI) were excluded. Patients were characterized as having undergone either a single-vessel infrapopliteal intervention or a multiple-vessel infrapopliteal intervention.ResultsOf the 673 limbs, 558 underwent a successful infrapopliteal endovascular intervention for CLI (86% for tissue loss, 14% for rest pain). During a single procedure, 503 limbs (90%) underwent a single-vessel intervention and 55 (10%) underwent a multiple-vessel intervention. Patients undergoing a single-vessel intervention more commonly underwent a prior ipsilateral endovascular procedure (17% vs 6%;P= .03) or a prior ipsilateral bypass procedure (20% vs 9%;P= .04). Kaplan-Meier analysis revealed that a RAS event ≤1 year occurred in 229 limbs (49%), with no significant difference in the 1-year rates of reintervention (22% vs 20%;P= .53), major amputation (16% vs 10%;P= .24), or stenosis (29% vs 21%;P= .25). After adjustment for baseline characteristics, multivariable regression illustrated that neither major amputation rates nor RAS events differed between patients undergoing a single-vessel vs a multiple-vessel intervention (P= .26 andP= .61, respectively).ConclusionsOur data suggest that a multiple-vessel intervention does not improve outcomes when compared to a single-vessel intervention following infrapopliteal angioplasty for CLI.
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DOI：
10.1583/03-1149.1
发表时间：
2004-06
期刊：
The Journal of Endovascular Therapy
影响因子：
--
作者：
E. Lipsitz;T. Ohki;F. Veith;S. Rhee;H. Kurvers;C. Timaran;N. Gargiulo;W. Suggs;R. Wain
通讯作者：
E. Lipsitz;T. Ohki;F. Veith;S. Rhee;H. Kurvers;C. Timaran;N. Gargiulo;W. Suggs;R. Wain
股浅动脉血管内介入早期失败的手术意义。
影响因子：
4.3
作者：
Charles S. Joels;J. York;C. Kalbaugh;D. Cull;E. Langan;Spence M. Taylor
通讯作者：
Spence M. Taylor
DOI：
--
发表时间：
2014
期刊：
影响因子：
--
作者：
J. Darling;J. McCallum;T. Curran;D. Buck;R. Guzman;M. Wyers;A. Hamdan;M. Schermerhorn
通讯作者：
M. Schermerhorn
腘窝下血管成形术治疗严重肢体缺血：跨大西洋社会共识类别与 176 条肢体结果的关系。
影响因子：
4.3
作者：
K. Giles;F. Pomposelli;T. L. Spence;A. Hamdan;Seth B. Blattman;Haig Panossian;M. Schermerhorn
通讯作者：
M. Schermerhorn
糖尿病患者股腘动脉冷冻成形术与传统球囊血管成形术：前瞻性随机单中心对照试验的长期结果
影响因子：
2.9
作者：
S. Spiliopoulos;K. Katsanos;D. Karnabatidis;A. Diamantopoulos;G. Kagadis;N. Christeas;D. Siablis
通讯作者：
D. Siablis