Document Detail


The final outcome of primary infrainguinal percutaneous transluminal angioplasty in 100 consecutive patients with chronic critical limb ischemia.
MedLine Citation:
PMID:  11997353     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was performed to determine final outcomes in patients treated with infrainguinal percutaneous transluminal angioplasty (PTA) for chronic critical limb ischemia (CLI). MATERIALS AND METHODS: The study population consisted of 100 consecutive patients (mean age, 72 y; range, 38-90 y; 40 men and 60 women) with 116 treated limbs. CLI was defined as rest pain or ischemic tissue defect combined with an ankle systolic pressure < or = 50 mm Hg. Indication for treatment was rest pain in 23 limbs (20%), ischemic ulcer in 50 (43%), and gangrene in 43 (37%). All patients were followed until they had met the study endpoints: major amputation or death. The mean follow-up period was 38 months (1-119 mo). Limb salvage, survival, and life with limb rates were determined along with their determinants. RESULTS: On average, 1.9 invasive procedures were required during the lifespan of a critically ischemic limb, including primary PTA and 32 repeat PTA procedures, 11 surgical revascularizations, and 51 amputations. The major amputation rate was 32% (n = 37). Limb salvage for endovascular treatments at 3, 5, and 8 years was 65%, 60%, and 60%, respectively (SE of estimate [SEE] <or = 0.06), and the corresponding life with limb rates were 29%, 18%, and 6% (SEE < or = 0.05). A greater number of diseased vessels in the treated limb was associated with poorer limb salvage (P =.004). Survival rates were 41%, 26%, and 14% (SEE < or = 0.05) at 3, 5, and 10 years. The 10-year survival rate was markedly poorer than that in the age- and sex-matched control population. Coronary artery disease (P =.001) and poor peripheral runoff (P =.02) were associated with decreased survival. CONCLUSIONS: Infrainguinal PTA in patients with CLI results in acceptable limb salvage with a low number of additional revascularization treatments, but patient survival is poor.
Authors:
Tiia Jämsén; Hannu Manninen; Harri Tulla; Pekka Matsi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  13     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-08     Completed Date:  2002-06-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  455-63     Citation Subset:  IM    
Affiliation:
Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, FIN-70200 Kuopio, Finland. tiia.jamsen@kuh.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon* / methods
Chronic Disease
Coronary Artery Disease / complications,  mortality,  therapy
Critical Illness
Extremities / blood supply*
Female
Follow-Up Studies
Hemodynamics / physiology
Humans
Inguinal Canal / surgery
Ischemia / complications,  mortality,  surgery*
Limb Salvage
Male
Middle Aged
Postoperative Complications / etiology,  mortality,  surgery
Prospective Studies
Reoperation
Survival Analysis
Treatment Outcome

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


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