Grzelązka Paweł, Koza Klaudia, Trofimiuk Adrianna, Suppan Karol, Wasielewski Marcin, Wiśniewska Joanna, Budzyński Jacek
Student Scientific Group, Chair of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Clinic of Vascular and Internal Diseases, Jan Biziel University Hospital No. 2, Bydgoszcz, Poland.
Postepy Kardiol Interwencyjnej. 2015;11(2):108-13. doi: 10.5114/pwki.2015.52283. Epub 2015 Jun 22.
About 20-30% of the population have peripheral artery disease. Many of them require intervention, with a percutaneous procedure currently being the first choice. However, the outcomes of these interventions need regular evaluation due to continuous progress in endovascular techniques and the devices used.
The aim of this study was to analyze procedural factors influencing the outcome of endovascular intervention in patients stented for the first time due to lower extremity atherosclerosis.
The medical documentation of 91 patients with at least 1 year of follow-up after stenting of a lower limb artery was retrospectively evaluated. Uni- and multivariate analyses were performed.
The mean observation time was 544.4 ±502.9 days. The primary patency of a stent after such a follow-up was 68.1%. Cox proportional hazard analysis revealed that the risk of target lesion revascularization was affected by the following (hazard risk, 95% confidence interval): the number of vascular segments with significant lesions (13.14, 2.28-75.8); critical limb ischemia (5.68, 1.23-26.2); localization of the target lesion in an aorto-iliac in comparison with a femoro-popliteal vascular segment (0.37, 0.14-0.7); aorto-iliac lesion class according to the TASC-II consensus (1.96, 1.1-3.8); and claudication distance (1.02, 1.01-1.03).
The common primary patency of a stent implanted into either an aorto-iliac or a femoro-popliteal vascular segment was similar to that found in other reports. The main factors affecting the outcome of the endovascular procedures performed were mainly related to atherosclerosis severity, not to the type of technique or device used.
约20%-30%的人群患有外周动脉疾病。其中许多人需要进行干预，目前经皮手术是首选。然而，由于血管内技术和所用器械的不断进步，这些干预的效果需要定期评估。
本研究的目的是分析影响首次因下肢动脉粥样硬化而接受支架置入术患者血管内干预效果的手术因素。
回顾性评估91例下肢动脉支架置入术后至少随访1年患者的医疗记录。进行单因素和多因素分析。
平均观察时间为544.4±502.9天。如此随访后支架的主要通畅率为68.1%。Cox比例风险分析显示，靶病变血运重建的风险受以下因素影响（风险比，95%置信区间）：有显著病变的血管节段数量（13.14，2.28-75.8）；严重肢体缺血（5.68，1.23-26.2）；与股腘血管节段相比，靶病变在主-髂动脉的定位（0.37，0.14-0.7）；根据TASC-II共识的主-髂动脉病变分级（1.96，1.1-3.8）；以及跛行距离（1.02，1.01-1.03）。
主-髂动脉或股腘血管节段植入支架的总体主要通畅率与其他报告相似。影响血管内手术效果的主要因素主要与动脉粥样硬化的严重程度有关，而与所用技术或器械的类型无关。
