HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Clinical efficacy of infrapopliteal endovascular procedures for hemodialysis patients with critical limb ischemia.

AbstractPURPOSE:
To investigate 5-year clinical outcomes after infrapopliteal endovascular therapy (EVT) for critical limb ischemia (CLI) patients on or not on hemodialysis (HD), and compare the clinical efficacy of EVT between the 2 groups.
METHODS:
The subjects were 1091 CLI patients (1310 limbs) who underwent EVT for isolated infrapopliteal lesions from 2004 to 2012, and were classified into 2 groups for comparative study: the patients on HD group (670 patients, 830 limbs) and not on HD group (421 patients, 480 limbs).
RESULTS:
The HD group had a significantly lower rate of freedom from major adverse limb events or perioperative death (HD 78.4% vs. non-HD 86.0% at 1 year, HD 70.3% vs. non-HD 82.4% at 5 years, P = 0.01), or amputation-free survival (AFS) rate (HD 65.7% vs. non-HD 78.7% at 1 year, HD 34.4% vs. non-HD 59.8% at 5 years, P < 0.01) after EVT compared with the non-HD group. Independent predictors of AFS in HD patients were nonambulatory, diabetes mellitus, albumin <3.0 g/dL, ejection fraction ≤0.48, and no patent pedal arch arteries before EVT. AFS at 1 year was 81% in patients with 0 or 1 predictor, surpassing the suggested AFS objective performance goal (OPG) end points of 68%, but AFS in patients with 2 or more predictors failed to reach the OPG.
CONCLUSIONS:
In comparison with non-HD patients, the clinical efficacy of infrapopliteal EVT for HD patients was poor. Preoperative risk stratification based on AFS predictors can be used as an index for predicting the prognosis.
AuthorsMasatsugu Nakano, Keisuke Hirano, Osamu Iida, Yasutaka Yamauchi, Yoshimitsu Soga, Daizo Kawasaki, Junichi Tazaki, Kenji Suzuki, Masahiko Fujiwara, Terutoshi Yamaoka
JournalAnnals of vascular surgery (Ann Vasc Surg) Vol. 29 Issue 6 Pg. 1225-34 (Aug 2015) ISSN: 1615-5947 [Electronic] Netherlands
PMID26004963 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
CopyrightCopyright © 2015 Elsevier Inc. All rights reserved.
Topics
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Angioplasty, Balloon (adverse effects, mortality)
  • Critical Illness
  • Disease-Free Survival
  • Female
  • Humans
  • Ischemia (diagnosis, mortality, therapy)
  • Japan
  • Kaplan-Meier Estimate
  • Limb Salvage
  • Lower Extremity (blood supply)
  • Male
  • Middle Aged
  • Peripheral Arterial Disease (diagnosis, mortality, therapy)
  • Popliteal Artery
  • Renal Dialysis (adverse effects, mortality)
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: