基于全球肢体解剖分期系统的腔内治疗治疗慢性肢体威胁性缺血的主要肢体通畅率。
Primary Limb-Based Patency for Chronic Limb-Threatening Ischemia Treated with Endovascular Therapy Based on the Global Limb Anatomic Staging System.
机构信息
Chinese Institutes for Medical Research, Beijing, Capital Medical University, Beijing, China.
Department of Vascular Surgery, The Southwest Hospital Affiliated to the Army Medical University, Chongqing, China.
出版信息
J Vasc Interv Radiol. 2024 Nov;35(11):1662-1672.e5. doi: 10.1016/j.jvir.2024.07.015. Epub 2024 Jul 24.
PURPOSE
To validate the correlation between the Global Limb Anatomic Staging System (GLASS) and primary limb-based patency (LBP) and to identify the risk factors associated with LBP loss.
MATERIALS AND METHODS
A single-center retrospective analysis was performed on patients with chronic limb-threatening ischemia (CLTI) who underwent endovascular therapy (EVT) between January 2018 and May 2022. All lesions were categorized into 3 groups (GLASS Stages I, II, and III). The primary LBP rates were analyzed and compared across the GLASS stages. The risk factors for the loss of primary LBP were identified using Cox regression analysis.
RESULTS
In total, 236 limbs from 231 patients were included, with 52 (22%) limbs stratified as GLASS Stage I, 59 (25%) limbs as GLASS Stage II, and 125 (53%) limbs as GLASS Stage III. The 1-year LBP rates for limbs classified as GLASS Stages I, II, and III were 78.8%, 69.5%, and 41.6%, respectively (P < .001). The long-term LBP rate was 54.2% in GLASS Stage I, 38.6% in GLASS Stage II, and 10.5% in GLASS Stage III (P < .001). Multivariate analysis revealed that GLASS stages (GLASS Stage Ⅰ vs Ⅲ, hazard ratio [HR], 0.36; 95% CI, 0.18-0.72; P = .004; GLASS Stage Ⅱ vs Ⅲ, HR, 0.47; 95% CI, 0.25-0.86; P = .02), diabetes, smoking, and sex were independently associated with LBP.
CONCLUSIONS
GLASS Stage III was associated with lower LBP rates in patients with CLTI who underwent EVT. The GLASS stages may serve as prognostic indicators for patients with CLTI after intervention.
目的
验证全球肢体解剖分期系统（GLASS）与主要肢体基础通畅率（LBP）之间的相关性，并确定与 LBP 丧失相关的风险因素。
材料和方法
对 2018 年 1 月至 2022 年 5 月期间接受血管内治疗（EVT）的慢性肢体威胁性缺血（CLTI）患者进行了单中心回顾性分析。所有病变均分为 3 组（GLASS 分期 I、II 和 III）。分析并比较了 GLASS 分期的主要 LBP 率。使用 Cox 回归分析确定 LBP 丧失的风险因素。
结果
共纳入 231 例患者的 236 条肢体，52 条（22%）肢体分为 GLASS 分期 I，59 条（25%）肢体分为 GLASS 分期 II，125 条（53%）肢体分为 GLASS 分期 III。GLASS 分期为 I、II 和 III 的肢体 1 年 LBP 率分别为 78.8%、69.5%和 41.6%（P<0.001）。GLASS 分期 I 的长期 LBP 率为 54.2%，GLASS 分期 II 为 38.6%，GLASS 分期 III 为 10.5%（P<0.001）。多变量分析显示，GLASS 分期（GLASS 分期 I 与 III，风险比[HR]，0.36；95%CI，0.18-0.72；P=0.004；GLASS 分期 II 与 III，HR，0.47；95%CI，0.25-0.86；P=0.02）、糖尿病、吸烟和性别与 LBP 独立相关。
结论
GLASS 分期 III 与接受 EVT 的 CLTI 患者较低的 LBP 率相关。GLASS 分期可能是 CLTI 患者介入治疗后的预后指标。
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