Document Detail


Endovascular revascularization below the knee: 6-month results and predictive value of C-reactive protein level.
MedLine Citation:
PMID:  12649419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the association between pre- and postintervention serum C-reactive protein (CRP) levels and 6-month restenosis after endovascular treatment of atherosclerotic lesions in arteries below the knee. MATERIALS AND METHODS: Eighty-nine patients with peripheral arterial disease underwent primary successful percutaneous transluminal angioplasty (PTA) of the distal popliteal, anterior tibial, posterior tibial, and fibular arteries. Six-month patency was evaluated with the ankle brachial index (ABI) and color-coded duplex ultrasonography (US). The association between restenosis and preintervention and 48-hour postintervention CRP levels was assessed with multiple logistic regression analysis. RESULTS: ABI improved from a preintervention median of 0.54 to a postintervention median of 0.75 (P <.001). The primary technical success rate was 94% (100 of 106). In 50 patients, a suboptimal technical result was achieved with 30%-40% residual stenosis at the dilated segment. The median ABI at 6 months was 0.65, and it was inversely correlated with preintervention (r = -0.27, P =.009) and 48-hour postintervention (r = -0.40, P <.001) CRP levels. With duplex US at 6 months, restenosis (> or =50%) occurred in 36 patients. Patients with a preintervention CRP level of 0.23-0.92 mg/dL (2.3-9.2 mg/L) had a 3.7-fold increased adjusted risk for restenosis (P =.05); patients with a preintervention CRP level greater than 0.92 mg/dL (9.2 mg/L) had a 4.7-fold increased adjusted risk (P =.03). Postintervention CRP values greater than 2.42 mg/dL (24.2 mg/L) were associated with a 10.7-fold adjusted risk for restenosis (P =.002). Suboptimal PTA result was the only other parameter associated with an increased risk for restenosis (odds ratio, 3.7; P =.03). CONCLUSION: Pre- and postintervention CRP levels were associated with restenosis after PTA of the distal popliteal and tibioperoneal arteries, which indicates that inflammation plays a crucial role in the pathophysiology of this process.
Authors:
Martin Schillinger; Markus Exner; Wolfgang Mlekusch; Markus Haumer; Helmut Rumpold; Ramazanali Ahmadi; Schila Sabeti; Oswald Wagner; Erich Minar
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Publication Detail:
Type:  Journal Article     Date:  2003-03-20
Journal Detail:
Title:  Radiology     Volume:  227     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-06     Completed Date:  2003-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  419-25     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2003
Affiliation:
Department of Angiology, University of Vienna Medical School, Währinger Gürtel 18-20, Austria. martin.schillinger@akh-wien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon* / adverse effects
Arteriosclerosis / blood*,  therapy*
Biological Markers / blood
C-Reactive Protein / analysis*
Female
Follow-Up Studies
Humans
Knee
Leg / blood supply*
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Recurrence
Chemical
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein
Comments/Corrections
Comment In:
Radiology. 2003 May;227(2):314-5   [PMID:  12732692 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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