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首页> 外文期刊>Journal of endovascular therapy: an official journal of the International Society of Endovascular Specialists >Clinically-driven need for secondary interventions after Endovascular revascularization of tibial arteries in patients with critical limb ischemia
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Clinically-driven need for secondary interventions after Endovascular revascularization of tibial arteries in patients with critical limb ischemia

机译：严重肢体缺血患者胫骨血管腔内血运重建后需要临床干预的临床驱动

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摘要

Purpose: To assess the need for clinically-driven secondary revascularization in critical limb ischemia (CLI) patients subsequent to tibial angioplasty during a 2-year follow-up. Methods: Between 2008 and 2010, a total of 128 consecutive CLI patients (80 men; mean age 76.5±9.8 years) underwent tibial angioplasty in 139 limbs. Rutherford categories, anklebrachial index measurements, and lower limb oscillometries were prospectively assessed. All patients were followed at 3, 6, 12 months, and annually thereafter. Rates of death, primary and secondary sustained clinical improvement, target lesion (TLR) and target extremity revascularization (TER), as well as major amputation, were analyzed retrospectively. Primary clinical improvement was defined as improvement in Rutherford category to a level of intermittent claudication without unplanned amputation or TLR. Results: All-cause mortality was 8.6%, 14.8%, 22.9%, and 29.1% at 3, 6, 12, and 24 months. At the same intervals, rates of primary sustained clinical improvement were 74.5%, 53.0%, 42.7%, and 37.1%; for secondary improvement, the rates were 89.1%, 76.0%, 68.4%, and 65.0%. Clinically-driven TLR rates were 14.6%, 29.1%, 41.6%, 46.2%; the rates for TER were 3.0%, 13.6%, 17.2%, and 27.6% in corresponding intervals, while the rates of major amputation were 1.5%, 5.5%, 10.1%, and 10.1%. Conclusion: Clinically-driven TLR is frequently required to maintain favorable functional clinical outcomes in CLI patients following tibial angioplasty. Dedicated technologies addressing tibial arterial restenosis warrant further academic scrutiny.
机译：目的：评估在2年的随访期间，胫骨血管成形术在严重肢体缺血（CLI）患者中临床驱动的二次血运重建的必要性。方法：2008年至2010年，共128例连续的CLI患者（80名男性;平均年龄76.5±9.8岁）在139肢中接受了胫骨血管成形术。前瞻性评估了卢瑟福类别，踝臂指数测量和下肢示波法。所有患者均在3、6、12个月及之后的每年随访。回顾性分析死亡率，原发性和继发性持续临床改善，目标病变（TLR）和目标肢端血运重建（TER）以及大截肢。主要的临床改善定义为卢瑟福类别的改善，达到间歇性lau行的水平，无计划外截肢或TLR。结果：在3、6、12和24个月时，全因死亡率分别为8.6％，14.8％，22.9％和29.1％。在相同的时间间隔内，原发性持续临床改善率分别为74.5％，53.0％，42.7％和37.1％;二级改善率分别为89.1％，76.0％，68.4％和65.0％。临床驱动的TLR发生率分别为14.6％，29.1％，41.6％，46.2％; TER的发生率分别为3.0％，13.6％，17.2％和27.6％，而大截肢的发生率分别为1.5％，5.5％，10.1％和10.1％。结论：胫骨血管成形术后，CLI患者通常需要临床驱动的TLR来维持良好的功能性临床结局。解决胫骨动脉再狭窄的专用技术值得进一步的学术审查。

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