Effect of perioperative complications after endovascular therapy in patients with peripheral artery disease due to femoropopliteal lesions.

Autor:	Sato K; Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan; Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan. Electronic address: satokei715@gmail.com., Iida O; Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan., Takahara M; Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan., Soga Y; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Suzuki K; Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan., Tanigawa T; Department of Cardiology, Matsusaka General Central Hospital, Matsusaka, Japan., Ito M; Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan., Uematsu M; Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
Jazyk:	angličtina
Zdroj:	Journal of vascular surgery [J Vasc Surg] 2015 May; Vol. 61 (5), pp. 1272-7.
DOI:	10.1016/j.jvs.2014.12.051
Abstrakt:	Objective: Despite wide use, high initial success, and acceptable durability of endovascular therapy (EVT) for femoropopliteal (FP) lesions, the frequency of 30-day perioperative complications (POCs) and their effect on clinical outcomes have not been systematically evaluated, which is the subject of this study. Methods: We used a multicenter database of 2145 consecutive patients (70% male; overall mean age, 73 ± 9 years) who successfully underwent EVT for FP lesions to investigate independent predictors of POCs (logistic regression analysis) and effect of POCs on prognostic outcomes (Cox proportional regression). Results: POCs were observed in 209 patients (10%). In multivariate logistic regression analysis, body mass index <18.5 kg/m(2), critical limb ischemia, and TransAtlanic Inter-Society Consensus for the Management of Peripheral Arterial Disease class D lesions were independently associated with POCs (adjusted odds ratios [95% confidence intervals], 2.0 [1.3-2.9], 2.5 [1.9-3.3], and 1.6 [1.2-2.1], respectively). After risk stratification of POCs according to the number of these risk factors, the incidence of POCs was higher in the groups with higher scores. Follow-up for >30 days (mean, 2.3 ± 1.8 years) was available for 2079 of 2145 patients. A Cox hazard regression model adjusted for baseline clinical characteristics showed POCs were negatively and independently associated with future occurrence of major adverse limb events (defined as major amputation and major reintervention) or death (hazard ratio [95% confidence interval], 1.6 [1.2-2.1]; P < .05). Conclusions: Body mass index <18.5 kg/m(2), critical limb ischemia, and TransAtlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease class D lesion were positively associated with POCs after EVT for FP lesions. The occurrence of POCs may adversely affect clinical outcomes in the chronic phase. (Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu