Huizing Eline, Schreve Michiel A, Kum Steven, Papageorgiou Grigorios, de Vries Jean-Paul P M, de Borst Gert J, Ünlü Çağdaş
Department of Surgery, Northwest Clinics, 1815 JD Alkmaar, The Netherlands.
Vascular Service, Department of Surgery, Changi General Hospital, Singapore 529889, Singapore.
Diagnostics (Basel). 2021 May 31;11(6):1008. doi: 10.3390/diagnostics11061008.
Percutaneous deep venous arterialization (pDVA) is a promising treatment option in patients with chronic limb-threatening ischemia. Stenosis and occlusions, which are the Achilles' heel of every revascularization procedure, can be treated when detected early. However, frequent monitoring after pDVA is required because when stenosis or occlusions develop is unknown. Therefore, patients currently need to visit the hospital every 2 weeks for surveillance, which can be burdensome. Accordingly, we aimed to develop a model that can predict future stenosis or occlusions in patients after pDVA to be able to create tailor-made follow-up protocols. The data set included 343 peak systolic velocity and 335 volume flow measurements of 23 patients. A stenosis or occlusion developed in 17 patients, and 6 patients remained lesion-free. A statistically significant increase in the risk of stenosis or occlusion was found when duplex ultrasound values decreased 20% within 1 month. The prediction model was also able to estimate a patient-specific risk of future stenosis or occlusions. This is promising for the possibility of reducing the frequency of follow-up visits for low-risk patients and increasing the frequency for high-risk patients. These observations are the starting point for individual surveillance programs in post-pDVA patients. Future studies with a larger cohort are necessary for validation of this model.
经皮深静脉动脉化（pDVA）是治疗慢性肢体威胁性缺血患者的一种有前景的治疗选择。狭窄和闭塞是所有血管重建手术的致命弱点，但如果能早期发现，就可以进行治疗。然而，pDVA术后需要频繁监测，因为狭窄或闭塞何时发生尚不清楚。因此，患者目前需要每2周去医院进行一次监测，这可能会带来负担。因此，我们旨在开发一种模型，能够预测pDVA术后患者未来的狭窄或闭塞情况，以便制定量身定制的随访方案。数据集包括23名患者的343次收缩期峰值流速和335次容积流量测量值。17名患者出现了狭窄或闭塞，6名患者无病变。当双功超声值在1个月内下降20%时，狭窄或闭塞的风险有统计学意义的增加。该预测模型还能够估计患者未来狭窄或闭塞的个体风险。这对于减少低风险患者的随访频率和增加高风险患者的随访频率具有前景。这些观察结果是pDVA术后患者个体监测计划的起点。未来需要更大队列的研究来验证该模型。
