| Impact of wound blush as an angiographic end point of endovascular therapy for patients with critical limb ischemia. | |
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MedLine Citation:
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PMID: 21943874 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Several reports have been published of the acceptable patency and limb salvage rates after infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic end point of endovascular therapy (EVT) remains unclear. This study assessed the relationship between the appearance of wound blush as an angiographic end point and the limb salvage rate in patients with CLI. METHODS: "Wound blush" was defined as contrast opacification of the vessels around the wound in digital subtraction angiograms obtained immediately after EVT through the catheter introduced into the popliteal artery. We analyzed the data of 77 consecutive patients (93 limbs) with ischemic ulcerations, classified as Rutherford category 5 or 6, who underwent EVT without bypass surgery. Patients were divided into two groups depending on whether wound blush was seen in the angiogram obtained immediately after the procedure. The freedom from amputation rate was compared between the two groups. RESULTS: The overall limb salvage rate was 81.7%. The limb salvage rate was significantly higher in the wound blush-positive group than in the wound blush-negative group and remained so for at least 3 years after the EVT (96.4% vs 56.8%, P < .001). CONCLUSIONS: Presence of wound blush after EVT is associated with higher skin perfusion pressure, both of which are associated with higher rates of limb salvage. Wound blush as an angiographic end point in EVT may be a novel predictor of limb salvage in patients with CLI. |
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Authors:
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Makoto Utsunomiya; Masato Nakamura; Mami Nakanishi; Takurou Takagi; Hidehiko Hara; Kiyoshi Onishi; Tetsuro Yamada; Kaoru Sugi |
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Publication Detail:
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Type: Journal Article Date: 2011-09-22 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 55 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2011-12-20 Completed Date: 2012-02-02 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 113-21 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, Japan. utsu0705@hotmail.co.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Amputation Angiography, Digital Subtraction* Angioplasty, Balloon* / instrumentation Chi-Square Distribution Contrast Media / diagnostic use Critical Illness Endpoint Determination Female Humans Ischemia / physiopathology, radiography*, therapy* Japan Kaplan-Meier Estimate Limb Salvage Lower Extremity / blood supply* Male Middle Aged Predictive Value of Tests Regional Blood Flow Retrospective Studies Skin / blood supply Stents Time Factors Treatment Outcome Wound Healing* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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