Saito Yuichi, Ohno Yuji, Yamamoto Kayo, Oka Norikiyo, Takahara Masayuki, Suzuki Sakuramaru, Uchiyama Raita, Suzuki Masahiro, Matsumoto Tadahiro, Iwata Yo, Kitahara Hideki, Kobayashi Yoshio
Department of Cardiovascular Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan.
Department of Cardiology, Japanese Red Cross Narita Hospital, Narita, Japan.
Cardiovasc Interv Ther. 2025 May 24. doi: 10.1007/s12928-025-01143-4.
Lower extremity peripheral arterial disease is usually a consequence of advanced atherosclerosis, leading to high mortality and morbidity. Although clinical characteristics and outcomes may differ among patients having peripheral disease in different arterial territories, contemporary data are scarce. From January 2019 to December 2022, this multicenter registry study included 712 patients undergoing endovascular treatment (EVT) for either aorto-iliac (AI) or femoropopliteal (FP) lesions. Patient characteristics and outcomes were compared between AI-EVT and FP-EVT groups. Clinical endpoints included major adverse cardiovascular events, major adverse limb events (MALE), and all-cause mortality, stratified by chronic limb-threatening ischemia (CLTI). Of the 712 patients, 217 (30.5%) and 495 (69.5%) underwent AI-EVT or FP-EVT. Patients undergoing AI-EVT were more likely to be men and current smokers, while diabetes was more frequent in the FP-EVT group. The prevalence of CLTI was significantly higher in the FP-EVT group. In the entire study population, the FP-EVT rather than the AI-EVT group had a significantly higher rate of MALE and mortality, but the incidence of major adverse cardiovascular events was similar between the two groups. When focusing only on patients without CLTI, the mortality risk was similar, while the MALE risk was still higher in the FP-EVT group. In conclusion, patients undergoing EVT for AI and FP lesions in contemporary settings were differently characterized by baseline factors. Although the worse clinical outcomes in the FP-EVT group were mainly driven by the higher prevalence of CLTI, the MALE risk was still increased in patients without CLTI.
下肢外周动脉疾病通常是晚期动脉粥样硬化的结果，会导致高死亡率和高发病率。尽管不同动脉区域患有外周疾病的患者其临床特征和预后可能有所不同，但当代数据却很匮乏。从2019年1月至2022年12月，这项多中心注册研究纳入了712例接受主动脉-髂动脉（AI）或股腘动脉（FP）病变血管内治疗（EVT）的患者。对AI-EVT组和FP-EVT组的患者特征及预后进行了比较。临床终点包括主要不良心血管事件、主要不良肢体事件（MALE）和全因死亡率，并按慢性肢体威胁性缺血（CLTI）进行分层。在这712例患者中，217例（30.5%）接受了AI-EVT，495例（69.5%）接受了FP-EVT。接受AI-EVT的患者更可能为男性且目前仍在吸烟，而糖尿病在FP-EVT组更为常见。CLTI的患病率在FP-EVT组显著更高。在整个研究人群中，FP-EVT组而非AI-EVT组的MALE和死亡率显著更高，但两组之间主要不良心血管事件的发生率相似。仅关注无CLTI的患者时，死亡风险相似，而FP-EVT组MALE风险仍然更高。总之，在当代环境中接受AI和FP病变EVT的患者，其基线因素特征不同。尽管FP-EVT组较差的临床结局主要是由CLTI的较高患病率所致，但无CLTI患者的MALE风险仍然增加。
