Department of Radiology, Ajou University School of Medicine, Suwon 443-721, Korea.
Korean J Radiol. 2013 May-Jun;14(3):430-8. doi: 10.3348/kjr.2013.14.3.430. Epub 2013 May 2.
To evaluate the impact on wound healing and long-term clinical outcomes of endovascular revascularization in patients with critical limb ischemia (CLI).
This is a retrospective study on 189 limbs with CLI treated with endovascular revascularization between 2008 and 2010 and followed for a mean 21 months. Angiographic outcome was graded to technical success (TS), partial failure (PF) and complete technical failure. The impact on wound healing of revascularization was assessed with univariate analysis and multivariate logistic regression models. Analysis of long-term event-free limb survival, and limb salvage rate (LSR) was performed by Kaplan-Meier method.
TS was achieved in 89% of treated limbs, whereas PF and CF were achieved in 9% and 2% of the limbs, respectively. Major complications occurred in 6% of treated limbs. The 30-day mortality was 2%. Wound healing was successful in 85% and failed in 15%. Impact of angiographic outcome on wound healing was statistically significant. The event-free limb survival was 79.3% and 69.5% at 1- and 3-years, respectively. The LSR was 94.8% and 92.0% at 1- and 3-years, respectively.
Endovascular revascularization improve wound healing rate and provide good long-term LSRs in CLI.
评估血管腔内血运重建术对伴有严重肢体缺血（CLI）患者的伤口愈合和长期临床结果的影响。
这是一项回顾性研究，纳入了 2008 年至 2010 年间接受血管腔内血运重建术治疗的 189 条伴有 CLI 的肢体，平均随访 21 个月。血管造影结果分为技术成功（TS）、部分失败（PF）和完全技术失败（CF）。通过单因素分析和多因素逻辑回归模型评估血管重建对伤口愈合的影响。采用 Kaplan-Meier 方法分析长期无事件保肢生存和保肢率（LSR）。
治疗肢体的 TS 达到 89%，PF 和 CF 分别为 9%和 2%。治疗肢体发生主要并发症的比例为 6%。30 天死亡率为 2%。伤口愈合成功 85%，失败 15%。血管造影结果对伤口愈合的影响具有统计学意义。无事件保肢生存分别为 1 年和 3 年的 79.3%和 69.5%。LSR 分别为 1 年和 3 年的 94.8%和 92.0%。
血管腔内血运重建术可提高 CLI 患者的伤口愈合率，并提供良好的长期 LSR。
