Angiographic Restenosis and Its Clinical Impact after Infrapopliteal Angioplasty

作者：Iida O^*; Soga Y; Kawasaki D; Hirano K; Yamaoka T; Suzuki K; Miyashita Y; Yokoi H; Takahara M; Uematsu M

来源：European Journal of Vascular and Endovascular Surgery, 2012, 44(4): 425-431.

DOI：10.1016/j.ejvs.2012.07.017

• Endovascular therapy
• Critical limb ischemia
• Angioplasty
• Angiographic restenosis

Objective: To assess 3- and 12-month angiographic restenosis rates and their clinical impact after infrapopliteal angioplasty. %26lt;br%26gt;Design: Prospective multicenter study. %26lt;br%26gt;Materials and methods: We analyzed 68 critical ischemic limbs (tissue loss: 58 limbs) from 63 consecutive patients due to isolated infrapopliteal lesions who underwent angioplasty alone. Primary endpoint was 3-month angiographic restenosis rate; secondary endpoints were 12-month angiographic restenosis rate, and 3- and 12-month rates of mortality, major amputation and reintervention. Three- and 12-month frequency of ambulatory status and of freedom from ischemic symptoms, and time to wound healing in the ischemic wound group, were compared between restenotic and non-restenotic groups. Angiographic restenosis predictors were assessed by multivariable analysis. %26lt;br%26gt;Results: 95% of cases had 3-month angiography; restenosis rate was 73%: 40% restenosis and 33% re-occlusion. Twelve-month follow-up angiography was conducted for the patients without 3-month angiographic restenosis, and restenosis rate at 12 months was 82%. Non-administration of cilostazol and statin, and chronic total occlusion were 3-month angiographic restenosis predictors. Three- and 12-month mortality was 5% and 12%, respectively. Despite no patients having undergone amputation, 15% had persistent ischemic symptoms, and 48% of limbs underwent reintervention within 12 months. During the same study period, ambulatory status and limbs with complete healing were more frequently observed in the non-restenosis group than in the restenosis group. In the tissue loss group, time to wound healing in the restenosis group was longer than in the non-restenosis group (127 days vs. 66 days, p = 0.02). %26lt;br%26gt;Conclusion: The extremely high angiographic restenosis rate after infrapopliteal angioplasty may adversely impact clinical status improvement.

• 出版日期2012-10