PMID- 36634898
OWN - NLM
STAT- MEDLINE
DCOM- 20230424
LR  - 20230424
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 92
DP  - 2023 May
TI  - High Global Limb Anatomic Staging System Femoropopliteal Grade is Positively 
      Associated with Wound Healing in Patients with Chronic Limb-Threatening Ischemia 
      Undergoing Endovascular Therapy Only for Femoropopliteal Disease.
PG  - 264-271
LID - S0890-5096(22)00895-0 [pii]
LID - 10.1016/j.avsg.2022.11.032 [doi]
AB  - BACKGROUND: To investigate the prognostic impact of femoropopliteal (FP) arterial 
      anatomic severity including classification by the global limb anatomic staging 
      system (GLASS) on wound healing in patients with chronic limb-threatening 
      ischemia (CLTI) who had undergone endovascular therapy (EVT) only for FP lesions. 
      METHODS: This was a retrospective single-center study. We treated 349 consecutive 
      de novo CLTI limbs with tissue loss from January 2017 to May 2021. Among these, 
      91 limbs treated via EVT only for FP lesions were enrolled. We compared the 
      clinical background, infrapopliteal (IP)/FP arterial anatomical characteristics, 
      and EVT results between the limbs with GLASS FP grade 1 or 2 (low GLASS FP, 
      n = 20) and those with GLASS FP grade 3 or 4 (high GLASS FP, n = 71). The 
      Kaplan-Meier method was used to estimate the wound healing rate. The Cox 
      proportional hazard model was used to assess the association between baseline 
      characteristics and wound healing. RESULTS: No patient underwent EVT for IP 
      lesions. IP arterial anatomical characteristics did not show any significant 
      difference between the low and high GLASS FP groups. The cumulative wound healing 
      rate after EVT was significantly higher in the high GLASS FP group than in the 
      low GLASS FP group (88% vs. 39% at 6 months; P < 0.001). Multivariate analysis 
      revealed that low wound, ischemia, and foot infection (WIfI) clinical stage 
      (stage 1 or 2) (hazard ratio [HR] 2.33; 95% confidence interval [CI] 1.32-4.17) 
      and high GLASS FP (grade 3 or 4) (HR 5.18; 95% CI 1.99-13.51) were independent 
      factors for wound healing. CONCLUSIONS: High GLASS FP grade was positively 
      associated with wound healing after EVT only for FP lesions.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Yanagiuchi, Takashi
AU  - Yanagiuchi T
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan. Electronic 
      address: takashi.yanagiuchi@gmail.com.
FAU - Kato, Taku
AU  - Kato T
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Hirano, Keita
AU  - Hirano K
AD  - Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, 
      Japan.
FAU - Hanabusa, Katsuyuki
AU  - Hanabusa K
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Ota, Yutaro
AU  - Ota Y
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Yamazaki, Shinya
AU  - Yamazaki S
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Fushimura, Yohei
AU  - Fushimura Y
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Ushimaru, Shunpei
AU  - Ushimaru S
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Yokoi, Hirokazu
AU  - Yokoi H
AD  - Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Zen, Kan
AU  - Zen K
AD  - Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, Japan.
FAU - Matoba, Satoaki
AU  - Matoba S
AD  - Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, Japan.
LA  - eng
PT  - Journal Article
DEP - 20230110
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Humans
MH  - Chronic Limb-Threatening Ischemia
MH  - Treatment Outcome
MH  - Risk Factors
MH  - Retrospective Studies
MH  - Limb Salvage/methods
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Amputation, Surgical
MH  - Lower Extremity/blood supply
MH  - *Endovascular Procedures/adverse effects
MH  - Ischemia/diagnostic imaging/surgery
MH  - Wound Healing
EDAT- 2023/01/13 06:00
MHDA- 2023/04/24 06:42
CRDT- 2023/01/12 19:22
PHST- 2022/10/21 00:00 [received]
PHST- 2022/11/22 00:00 [revised]
PHST- 2022/11/29 00:00 [accepted]
PHST- 2023/04/24 06:42 [medline]
PHST- 2023/01/13 06:00 [pubmed]
PHST- 2023/01/12 19:22 [entrez]
AID - S0890-5096(22)00895-0 [pii]
AID - 10.1016/j.avsg.2022.11.032 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2023 May;92:264-271. doi: 10.1016/j.avsg.2022.11.032. Epub 2023 
      Jan 10.