Six-month clinical outcomes after below-the-knee angioplasty for critical limb ischemia in patients on hemodialysis
- PDF / 309,444 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 65 Downloads / 155 Views
ORIGINAL ARTICLE
Six-month clinical outcomes after below-the-knee angioplasty for critical limb ischemia in patients on hemodialysis Masatsugu Nakano • Toshiya Muramatsu • Keisuke Hirano • Reiko Tsukahara • Yoshiaki Itou Hiroshi Ishimori
•
Received: 17 October 2009 / Accepted: 7 April 2010 / Published online: 15 May 2010 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2010
Abstract To evaluate 6-month clinical outcomes after below-the-knee (BTK) angioplasty for critical limb ischemia (CLI) in patients on hemodialysis (HD). Subjects were 69 serial patients (81 limbs, 123 vessels) who underwent percutaneous transluminal angioplasty (PTA) for primary treatment of infrapopliteal lesions in CLI from June 2004 to December 2008. Subjects were classified into two groups for the comparative study of clinical outcomes: the patients on HD: the HD group (35 patients, 45 limbs, 71 vessels, 66 ± 11 years) and the patients not on HD: the non-HD group (34 patients, 36 limbs, 52 vessels, 69 ± 9 years). A non-randomized retrospective comparative study was conducted to obtain clinical outcomes at 6 months. In clinical results at 6 months, a higher percentage of tendency toward repeat PTA for the treated leg in the HD group (28.9 vs. 11.1%, p = 0.059), but it was not statistically significant. There was no significant difference in the rate of major amputation (11.1 vs. 5.5%) between the two groups. However, the percentage of repeat PTA performed twice or more times (13.3 vs. 0%, p = 0.031) and all-cause mortality (17.1 vs. 0%, p = 0.012) in the HD group was significantly higher than in the non-HD group. The HD group had a significantly lower rate of freedom from all-cause mortality, major amputation, or repeat PTA in the 6-month follow-up compared to the non-HD group, with the HD group 51.4%
M. Nakano (&) T. Muramatsu K. Hirano R. Tsukahara Y. Itou H. Ishimori Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama 230-0012, Japan e-mail: [email protected]
and the non-HD group 85.3% (logrank test p = 0.003). Although there are more HD patients requiring repeat revascularization compared to the general population, the 6-month outcomes of limb salvage after BTK angioplasty for CLI in HD patients were not significantly different from the general population. Keywords Critical limb ischemia Hemodialysis Angioplasty
Background Peripheral artery disease (PAD) is a common disease in patients undergoing hemodialysis (HD) [1]. The less invasive percutaneous transluminal angioplasty (PTA) as the primary treatment of PAD is feasible and effective in dialysis patients [2, 3]. However, HD is a strong predictor of amputation and all-cause mortality after PTA for PAD in the general population [2]. It has also been reported that critical limb ischemia (CLI) with HD patients is a predictor for restenosis, amputation, or death in long-term outcomes after PTA [2, 4]. CLI is the most severe form of PAD in which there is inadequate blood flow to a l
Data Loading...
