[Influencing factor analysis of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis].

OBJECTIVE

To analyze the influencing factors of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis.

METHODS

Between January 2009 and December 2010, 59 patients (67 limbs) with chronic limb ischemia associated with acute thrombosis were treated. According to whether the no-reflow phenomenon occurred or not, the patients were divided into no-reflow group (19 patients, 21 limbs) and reflow group (40 patients, 46 limbs). Logistic regression was used to analyze the roles of ischemia time, ischemia extent, smoking, hypertension, cardiovascular and cerebrovascular disease, diabetes, surgical procedure, platelet count, fibrinogen (FBG), prostaglandin 12 (PGI2), and thromboxane A2 (TXA2) on no-reflow phenomenon after reperfusion.

RESULTS

The results of the logistic regression analysis indicated that ischemia time (OR =7.196; 95%CI: 1.679-27.960), ischemia extent (OR = 5.116; 95% CI: 1.399-109.338), smoking (OR = 6.893; 95% CI: 3.704-2 291.003), diabetes (OR = 3.864; 95% CI: 1.009-421.702), PGI2 (OR = 7.985; 95% CI: 1.001-1.043), and TXA2 (OR = 7.643; 95% CI: 1.011-1.065) were the high risk factors of no-reflow phenomenon. The levels of TXA2 and FBG in no-reflow group were significantly increased and the level of PGI2 was decreased, showing significant differences when compared with the reflow group (P < 0.05). However, no significant difference was found in the platelet count between 2 groups (P > 0.05).

CONCLUSION

Ischemia extent and ischemia time are the main influencing factors of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis, and the patients combined with smoking or diabetes are high risk population of the no-reflow phenomenon. Postoperative patients with no-reflow phenomenon are at a hypercoagulable state in vivo, in which prostacyclin plays an important role.