Document Detail

Impact of wound blush as an angiographic end point of endovascular therapy for patients with critical limb ischemia.
MedLine Citation:
PMID:  21943874     Owner:  NLM     Status:  MEDLINE    
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.
Makoto Utsunomiya; Masato Nakamura; Mami Nakanishi; Takurou Takagi; Hidehiko Hara; Kiyoshi Onishi; Tetsuro Yamada; Kaoru Sugi
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Publication Detail:
Type:  Journal Article     Date:  2011-09-22
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-20     Completed Date:  2012-02-02     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-21     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, Japan.
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MeSH Terms
Aged, 80 and over
Angiography, Digital Subtraction*
Angioplasty, Balloon* / instrumentation
Chi-Square Distribution
Contrast Media / diagnostic use
Critical Illness
Endpoint Determination
Ischemia / physiopathology,  radiography*,  therapy*
Kaplan-Meier Estimate
Limb Salvage
Lower Extremity / blood supply*
Middle Aged
Predictive Value of Tests
Regional Blood Flow
Retrospective Studies
Skin / blood supply
Time Factors
Treatment Outcome
Wound Healing*
Reg. No./Substance:
0/Contrast Media

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

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