Document Detail


Differences in patterns of peripheral arterial occlusive disease and eligibility for endovascular treatment.
MedLine Citation:
PMID:  23129039     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: To analyze differences in morphological changes in the vascular tree among patients presenting with intermittent claudication (IC) and critical limb ischemia (CLI). In addition, suitability for endovascular treatment was evaluated. Patients and methods: Our study included 690 lower extremities with IC or CLI in 500 consecutive patients who were assessed by magnetic resonance angiography (MRA) according to the TASC II classification and in terms of the below the knee run-off status. Multivariable logistic regressions models adjusted for cardiovascular risk factors were used to evaluate differences in arteriosclerotic lesion patterns and eligibility for endovascular treatment. Results: Multivariable analysis showed that compared with IC extremities, CLI extremities have significantly more severe arteriosclerotic lesions at the aortoiliac (p < 0.001), femoropopliteal (p < 0.001), and crural levels (p < 0.001), with a greater risk of multilevel disease (odds ratio [OR], 1.71; 95 % confidence interval [CI] 1.10 - 2.66; p = 0.018). More than 80 % of extremities with IC and more than 50 % of extremities with CLI appeared to be eligible for endovascular treatment in an isolated evaluation of the aortoiliac and femoropopliteal axis. For combined evaluation of the aortoiliac and femoropopliteal axis, the proportion of endovascular suitability (TASC A+B lesions) decreased to 65 % (IC) and 41 % (CLI). For TASC A+B+C lesions, the proportions were 79 % (IC) and 41 % (CLI). Conclusions: Lower extremities with IC and CLI significantly differ in terms of arteriosclerotic lesion morphology and patterns of lesion localization. The majority of IC and CLI extremities appear to be eligible for endovascular treatment. Because of further improvement in endovascular equipment, even more patients will be eligible for treatment.
Authors:
A Zimmermann; F Arzt; M Wildgruber; T Schuster; H Wendorff; H-H Eckstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  VASA. Zeitschrift für Gefässkrankheiten     Volume:  41     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  432-9     Citation Subset:  IM    
Affiliation:
Clinic for Vascular and Endovascular Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
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