Mathur K, Ayyappan M K, Hodson J, Hopkins J, Tiwari A, Duddy M, Vohra Rajiv
Department of Vascular Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Wolfson Computer Laboratory, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Vasc Endovascular Surg. 2015 Apr-May;49(3-4):63-8. doi: 10.1177/1538574415591001. Epub 2015 Jun 16.
To study factors affecting patency and medium-term outcomes after crural angioplasty.
All crural angioplasties between March 2003 and September 2010 were reviewed from a prospective database to analyze primary patency, amputation-free survival, and limb salvage.
Five hundred and twenty-seven limbs in 478 patients (58.7% male, mean age 73.9 ± 0.53 years) were treated. In all, 49.1% were diabetic patients and 7.4% were dialysis dependent. Primary patency was 65.5%, 57.8%, 48.5%, and 32.9% at 1, 6, 12, and 36 months, respectively. Amputation-free survival was 75.2% at 1 year and 59.0% at 3 years. Limb salvage at 3 years was 92.7%. Rutherford categories 5 and 6 had a consistent adverse effect on patency. This led to an adverse amputation-free survival and limb salvage at 3 years.
Crural angioplasty is an effective treatment for limb salvage. Its outcomes are adversely affected by diabetes, renal disease, coronary disease, and worsening Rutherford grade.
研究影响足部血管成形术后通畅率及中期预后的因素。
回顾性分析2003年3月至2010年9月前瞻性数据库中所有的足部血管成形术病例，分析其初始通畅率、无截肢生存率及肢体挽救情况。
共治疗478例患者的527条肢体（男性占58.7%，平均年龄73.9±0.53岁）。其中，49.1%为糖尿病患者，7.4%依赖透析治疗。1、6、12和36个月时的初始通畅率分别为65.5%、57.8%、48.5%和32.9%。1年时的无截肢生存率为75.2%，3年时为59.0%。3年时的肢体挽救率为92.7%。Rutherford分级5级和6级对通畅率有持续的不利影响，导致3年时无截肢生存率和肢体挽救情况不佳。
足部血管成形术是挽救肢体的有效治疗方法。糖尿病、肾脏疾病、冠状动脉疾病及Rutherford分级恶化对其预后有不利影响。
