Document Detail


Long-term outcome after percutaneous peripheral intervention vs medical treatment for patients with superficial femoral artery occlusive disease.
MedLine Citation:
PMID:  18441452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous peripheral intervention (PPI) for superficial femoral artery (SFA) stenosis is associated with a high restenosis rate. Whether PPI improves the long-term outcome of patients with SFA occlusive disease remains to be determined. METHODS AND RESULTS: A review was done of 107 patients with SFA occlusive disease. Fifty-five patients received PPI for SFA (ie, PPI group) and 52 patients received conservative medical therapy (ie, control group). Clinical records were searched for adverse events (eg, death, limb amputation, re-hospitalization, new onset of coronary artery disease and cerebrovascular disease) for an average of 30.6+/-17.7 months. At follow-up, only 5 patients (9.1%) in the PPI group experienced improved limb symptoms compared with baseline, and 6 patients (10.9%) showed ischemic skin ulcer or gangrene. In addition, 2 of these 6 patients were unsuccessful PPI cases complicated with distal embolization and perforation. In the control group, 3 patients (5.8%) presented with improved limb symptoms, and an equal number of patients had worsening of symptoms. Although 2 patients showed ischemic skin ulcers at follow-up, both patients had these lesions at baseline. Adverse events were observed more frequently in the PPI group than the control group (69.1% vs 46.2%, p<0.05). This was mainly due to a higher frequency of re-hospitalization in the PPI group than in controls (52.7% vs 15.4%, p<0.001). CONCLUSIONS: The current study demonstrates that PPI for patients with SFA occlusive disease does not provide superior long-term benefits compared with conservative medical therapy, and that medical therapy will continue to remain the primary treatment strategy for this group of patients.
Authors:
Chizuko Kamiya; Shingo Sakamoto; Yuiichi Tamori; Tsuyoshi Yoshimuta; Masahiro Higashi; Ryoichi Tanaka; Koichi Akutsu; Satoshi Takeshita
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-09-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  734-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, National Cardiovascular Center, Suita, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amputation / statistics & numerical data
Angioplasty, Balloon* / adverse effects
Arterial Occlusive Diseases / drug therapy,  mortality,  therapy*
Comorbidity
Coronary Artery Disease / mortality
Female
Femoral Artery*
Follow-Up Studies
Humans
Intermittent Claudication / drug therapy,  mortality,  therapy*
Kaplan-Meiers Estimate
Male
Medical Records
Middle Aged
Risk Factors
Treatment Outcome

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


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