PMID- 36162626
OWN - NLM
STAT- MEDLINE
DCOM- 20230124
LR  - 20230202
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 89
DP  - 2023 Feb
TI  - Risk Factor Analysis and Long-Term Outcomes in Patients with Endovascular 
      Revascularization for Intermittent Claudication or Chronic Limb-Threatening 
      Ischemia.
PG  - 261-268
LID - S0890-5096(22)00573-8 [pii]
LID - 10.1016/j.avsg.2022.09.038 [doi]
AB  - BACKGROUND: The aim of this study is to review long-term outcome and identify 
      risk factors for patients with peripheral arterial disease (PAD) with 
      percutaneous transluminal angioplasty/stent as a primary treatment strategy for 
      intermittent claudication (IC) or chronic limb-threatening ischemia (CLTI). 
      METHODS: A retrospective cohort study with data collected prospectively from 
      Clinical Data Analysis and Reporting System, departmental database, and Clinical 
      Management System. All patients who underwent endovascular procedures for PAD 
      between January 2011 and December 2020 were identified. The primary outcomes are 
      overall survival and amputation-free survival. Predictive factors for OS and AFS 
      were determined using Cox Model. RESULTS: A total number of 640 patients with PAD 
      (IC, n = 243; CLTI, n = 377) underwent endovascular percutaneous transluminal 
      angioplasty/stenting for PAD from January 2011 to December 2020. Patients with 
      CLTI had a significantly higher 30 days readmission rate (18.8% vs. 6.5%, 
      P < 0.001), emergency reoperation within 30 days (3.4% vs. 0%, P = 0.002), and 
      death within same admission (2.7% vs. 0%, P = 0.008) compared to IC patients. The 
      overall survival and amputation-free survival rates were significantly lower in 
      CLTI patients (P < 0.0001 and P < 0.0001, respectively). On Cox multivariate 
      analysis, CLTI was strongly predictive of all-cause mortality and amputation 
      (hazard ratio [HR] 2.33 and HR 14.92, respectively). In patients with CLTI, 
      chronic kidney disease was an independent predictor of mortality and amputation 
      (HR 1.66 and HR 2.36, respectively). Smoking and ischemic heart disease were also 
      independent predictors of mortality in this subgroup (HR 2.06 and HR 2.43, 
      respectively). CONCLUSIONS: Although patients with IC and CLTI both manifest from 
      atherosclerotic occlusive disease of the lower limb arteries, these patients may 
      have different clinical outcomes with significant mortality occurred in both IC 
      and CLTI groups. In patients with IC, the risk of amputation was less than 1% at 
      5 years following revascularization.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Fung, Victor
AU  - Fung V
AD  - Division of Vascular & Endovascular Surgery, Department of Surgery, University of 
      Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
FAU - Chan, Yiu Che
AU  - Chan YC
AD  - Division of Vascular & Endovascular Surgery, Department of Surgery, University of 
      Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China. Electronic 
      address: ycchan88@hkucc.hku.hk.
FAU - Cheung, Grace C
AU  - Cheung GC
AD  - Division of Vascular & Endovascular Surgery, Department of Surgery, University of 
      Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
FAU - Cheng, Stephen W
AU  - Cheng SW
AD  - Division of Vascular & Endovascular Surgery, Department of Surgery, University of 
      Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
LA  - eng
PT  - Journal Article
DEP - 20220924
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Humans
MH  - Intermittent Claudication/diagnostic imaging/therapy
MH  - Chronic Limb-Threatening Ischemia
MH  - Retrospective Studies
MH  - Limb Salvage
MH  - Ischemia/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Risk Factors
MH  - *Endovascular Procedures
MH  - Chronic Disease
EDAT- 2022/09/27 06:00
MHDA- 2023/01/25 06:00
CRDT- 2022/09/26 19:35
PHST- 2022/07/18 00:00 [received]
PHST- 2022/09/09 00:00 [revised]
PHST- 2022/09/15 00:00 [accepted]
PHST- 2022/09/27 06:00 [pubmed]
PHST- 2023/01/25 06:00 [medline]
PHST- 2022/09/26 19:35 [entrez]
AID - S0890-5096(22)00573-8 [pii]
AID - 10.1016/j.avsg.2022.09.038 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2023 Feb;89:261-268. doi: 10.1016/j.avsg.2022.09.038. Epub 2022 
      Sep 24.