PMID- 32224557
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20211014
IS  - 1880-3873 (Electronic)
IS  - 1340-3478 (Print)
IS  - 1340-3478 (Linking)
VI  - 28
IP  - 1
DP  - 2021 Jan 1
TI  - The Association of Preoperative Characteristics with Reintervention Risk in 
      Patients Undergoing Revascularization for Chronic Limb-Threatening Ischemia.
PG  - 52-65
LID - 10.5551/jat.54866 [doi]
AB  - AIM: To investigate the associations between preoperative characteristics and the 
      risk of reintervention in patients undergoing revascularization for chronic 
      limb-threatening ischemia (CLTI) in a contemporary real-world setting. METHODS: 
      We retrospectively analyzed data from a clinical database formed by the Surgical 
      Reconstruction Versus Peripheral Intervention in Patients With Critical Limb 
      Ischemia (SPINACH) study, which was a multicenter, prospective, observational 
      study. The study population was composed of 520 CLTI patients with the wound, 
      ischemia, and foot infection (WIfI) classes I-3 with resting pain or classes 
      I-2/3 with ulcers/gangrene. Of the 520 patients, 192 had surgical reconstruction 
      planned, whereas 328 had endovascular therapy (EVT) alone planned at the time of 
      registration. The current analysis was conducted to explore the associations 
      between preoperative characteristics and the risk of reintervention. RESULTS: A 
      total of 452 participants (87%) completed the 3-year follow-up regarding 
      reintervention. The competing risk analysis estimated that the three-year 
      cumulative incidence rates for reintervention and reintervention-free deaths were 
      44.0% and 28.7%, respectively. No preoperative characteristics had a significant 
      interaction effect with EVT versus surgical reconstruction. The risk analysis 
      identified the following independent risk factors for reintervention: 1) EVT 
      instead of bypass reconstruction, 2) renal dysfunction, 3) history of 
      revascularization after CLTI onset (i.e., requirement of redo revascularization 
      for CLTI), and 4) bilateral CLTI. Patients with more than one of these risk 
      factors had an increased risk of reintervention. CONCLUSIONS: The current study 
      identified preoperative characteristics associated with an increased risk of 
      reintervention. No preoperative characteristics had any significant interactions 
      with EVT or surgical reconstruction.
FAU - Iida, Osamu
AU  - Iida O
AD  - Cardiovascular Center, Kansai Rosai Hospital.
FAU - Takahara, Mitsuyoshi
AU  - Takahara M
AD  - Department of Diabetes Care Medicine and Department of Metabolic Medicine, Osaka 
      University Graduate School of Medicine.
FAU - Soga, Yoshimitsu
AU  - Soga Y
AD  - Department of Cardiology, Kokura Memorial Hospital.
FAU - Kodama, Akio
AU  - Kodama A
AD  - Division of Vascular Surgery, Department of Surgery, Nagoya University School of 
      Medicine.
FAU - Terashi, Hiroto
AU  - Terashi H
AD  - Kobe University Graduate School of Medicine, Department of Plastic Surgery.
FAU - Azuma, Nobuyoshi
AU  - Azuma N
AD  - Department of Vascular Surgery, Asahikawa Medical University.
CN  - SPINACH investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20200328
PL  - Japan
TA  - J Atheroscler Thromb
JT  - Journal of atherosclerosis and thrombosis
JID - 9506298
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Endovascular Procedures
MH  - Extremities/*blood supply/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Ischemia/epidemiology/physiopathology/*surgery
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - Preoperative Period
MH  - Prospective Studies
MH  - Treatment Outcome
PMC - PMC7875141
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - Endovascular therapy
OT  - Reintervention
OT  - Surgical reconstruction
COIS- There are no conflicts of interest regarding this manuscript.
EDAT- 2020/04/01 06:00
MHDA- 2021/10/15 06:00
PMCR- 2021/01/01
CRDT- 2020/04/01 06:00
PHST- 2020/04/01 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2020/04/01 06:00 [entrez]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.5551/jat.54866 [doi]
PST - ppublish
SO  - J Atheroscler Thromb. 2021 Jan 1;28(1):52-65. doi: 10.5551/jat.54866. Epub 2020 
      Mar 28.