PMID- 38072421
OWN - NLM
STAT- MEDLINE
DCOM- 20240312
LR  - 20240312
IS  - 1347-3409 (Electronic)
IS  - 1345-4676 (Linking)
VI  - 91
IP  - 1
DP  - 2024 Mar 9
TI  - Effectiveness of Repetitive Hyperbaric Oxygen Therapy for Chronic 
      Limb-Threatening Ischemia.
PG  - 66-73
LID - 10.1272/jnms.JNMS.2024_91-106 [doi]
AB  - BACKGROUND: Lower extremity artery disease is strongly associated with morbidity 
      and is typically addressed through revascularization interventions. We assessed 
      the clinical outcomes of patients with chronic limb-threatening ischemia (CLTI) 
      without revascularization who did and did not undergo repetitive hyperbaric 
      oxygen therapy (HBOT). METHODS: Between April 2002 and March 2017, the records of 
      58 patients with CLTI (Rutherford classification 4 in 19% and 5 in 81%) were 
      evaluated retrospectively. HBOT was performed at 2.8 atm of oxygen (HBOT group). 
      The control group included those who could not continue HBOT and historical 
      controls. Patients in poor general health or with an indication for 
      revascularization therapy were excluded. We examined major adverse events (MAEs) 
      and limb salvage rates. Independent predictors and risk stratification were 
      analyzed using a multivariate regression analysis. RESULTS: The mean age was 
      71+/-13 years. Of all patients, 67% had diabetes and 43% were undergoing 
      hemodialysis. The mean follow-up period was 4.3+/-0.8 years. The overall survival 
      rate was 84.5% and 81.0% at 1 and 3 years, respectively. The Cox regression 
      analysis indicated that high body mass index (odds ratio [OR]: 0.86; 95% 
      confidence interval [CI]: 0.76-0.97; p=0.01), well-nourished (OR: 1.21; 95% CI: 
      1.01-1.45), and HBOT (OR: 0.05; 95% CI: 0.01-0.26; p<0.001) independently 
      predicted absence of MAEs. For major limb amputation, the ankle-brachial index 
      (OR: 0.2; 95% CI: 0.05-0.86; p=0.03) and HBOT (OR: 0.04; 95% CI: 0.004-0.32; 
      p=0.003) were independent predictors. CONCLUSIONS: Repetitive, stand-alone HBOT 
      was associated with MAE-free survival and limb salvage in patients with CLTI.
FAU - Takagi, Gen
AU  - Takagi G
AD  - Department of Cardiovascular Medicine, Nippon Medical School.
FAU - Kirinoki-Ichikawa, Sonoko
AU  - Kirinoki-Ichikawa S
AD  - Department of Cardiovascular Medicine, Nippon Medical School.
FAU - Tara, Shuhei
AU  - Tara S
AD  - Department of Cardiovascular Medicine, Nippon Medical School.
FAU - Takagi, Ikuyo
AU  - Takagi I
AD  - Department of Cardiovascular Medicine, Nippon Medical School.
FAU - Miyamoto, Masaaki
AU  - Miyamoto M
AD  - Department of Cardiovascular Medicine, Nippon Medical School.
LA  - eng
PT  - Journal Article
DEP - 20231208
PL  - Japan
TA  - J Nippon Med Sch
JT  - Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
JID - 100935589
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Limb-Threatening Ischemia
MH  - *Peripheral Arterial Disease/therapy
MH  - *Hyperbaric Oxygenation/adverse effects
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ischemia/therapy
MH  - Risk Factors
MH  - Chronic Disease
MH  - *Endovascular Procedures
OTO - NOTNLM
OT  - chronic limb-threatening ischemia
OT  - hyperbaric oxygen therapy
OT  - lower extremity artery disease
EDAT- 2023/12/11 00:42
MHDA- 2024/03/12 06:43
CRDT- 2023/12/10 20:13
PHST- 2024/03/12 06:43 [medline]
PHST- 2023/12/11 00:42 [pubmed]
PHST- 2023/12/10 20:13 [entrez]
AID - 10.1272/jnms.JNMS.2024_91-106 [doi]
PST - ppublish
SO  - J Nippon Med Sch. 2024 Mar 9;91(1):66-73. doi: 10.1272/jnms.JNMS.2024_91-106. 
      Epub 2023 Dec 8.