Do thrombotic events during endovascular interventions lead to poorer outcomes in patients with severe limb ischemia?

Autor:	Chia D; Ministry of Health Holdings, Singapore., May KK; Department of Cardiothoracic and Vascular Surgery, National University Health System, Singapore., Zaw MH; Department of Surgery, National University of Singapore, Singapore., Hartman M; Department of Surgery, National University of Singapore, Singapore., Robless PA; Department of Cardiothoracic and Vascular Surgery, National University Health System, Singapore., Ho P; Department of Cardiothoracic and Vascular Surgery, National University Health System, Singapore surhp@nus.edu.sg.
Jazyk:	angličtina
Zdroj:	Vascular [Vascular] 2015 Jun; Vol. 23 (3), pp. 245-52. Date of Electronic Publication: 2014 Aug 19.
DOI:	10.1177/1708538114546367
Abstrakt:	Introduction: Intra-procedural acute thrombosis (IPAT) is a complication of endovascular procedures. We aim to identify risk factors for IPAT and compare the outcomes of patients with or without IPAT. Methods: Paired T test and χ (2) test were used to identify risk factors and short-term outcomes. Kaplan-Meier survival analysis was used for mid-term outcomes. Results: A total of 228 procedures were performed with 21 IPAT events (9.21%). The odds ratio of Indian patients developing IPAT was 2.8x (95% CI 1.1-7.6). Patients with in-stent occlusion or prior IPAT were 5.6x (95% CI 1.3-24.2) and 5.6x (95% CI 1.3-24.4) more likely to develop an IPAT event. Patients without IPAT had significantly more improvement in mean runoff score (-1.15 ± 1.31, p < 0.01). The odds of patients with IPAT requiring subsequent endovascular intervention and arterial bypass surgery were 4.2x (95% CI 1.6-10.7) and 7.1x (95% CI 1.9-27.0). There was no significant Kaplan-Meier estimated overall survival or amputation-free survival difference between patients with or without IPAT event. Conclusion: Indian ethnicity, in-stent occlusion and previous IPAT were associated with higher risk of IPAT. Even after successful endovascular salvage, patients with IPATs were more likely to require secondary revascularization procedure. Patients with IPATs had no decrease in overall survival or amputation-free survival. (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu