Arterial calcification and long-term outcome in chronic limb-threatening ischemia patients.

Autor: Konijn LC; Haga Hospital, Department of Diagnostic and Interventional Radiology, the Netherlands; University Medical Center Utrecht and Utrecht University, Department of Radiology, the Netherlands. Electronic address: l.c.d.konijn@umcutrecht.nl., Takx RA; University Medical Center Utrecht and Utrecht University, Department of Radiology, the Netherlands. Electronic address: r.a.p.takx@umcutrecht.nl., de Jong PA; University Medical Center Utrecht and Utrecht University, Department of Radiology, the Netherlands. Electronic address: p.dejong-8@umcutrecht.nl., Spreen MI; Haga Hospital, Department of Diagnostic and Interventional Radiology, the Netherlands. Electronic address: mi.spreen@gmail.com., Veger HT; Haga Hospital, Department of Vascular Surgery, the Netherlands. Electronic address: h.veger@hagaziekenhuis.nl., Mali WP; University Medical Center Utrecht and Utrecht University, Department of Radiology, the Netherlands. Electronic address: w.mali@umcutrecht.nl., van Overhagen H; Haga Hospital, Department of Diagnostic and Interventional Radiology, the Netherlands. Electronic address: h.voverhagen@hagaziekenhuis.nl.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2020 Nov; Vol. 132, pp. 109305. Date of Electronic Publication: 2020 Sep 28.
DOI: 10.1016/j.ejrad.2020.109305
Abstrakt: Purpose: Within five years after presentation 50-60% of patients with chronic limb-threatening ischemia (CLI) have died or had an amputation. We assessed the predictive value of lower extremity arterial calcification on computed tomography (CT) characteristics on both 7-years amputation-free survival and 10-years all-cause mortality in patients with CLI.
Method: Included were 89 CLI patients (mean age 73.1 ± 11.6 years) who underwent a CT angiography of the lower extremities. In the femoropopliteal and crural arteries based on a CT score the following calcification characteristics were assessed: severity, annularity, thickness and continuity. The predictive value of different arterial calcification characteristics was analysed by age- and sex-adjusted multivariate Cox regression analysis.
Results: Complete annular calcifications were common (femoropopliteal 43.7%, n = 38; crural, 63.2%, n = 55). Mean survival was 278.4 weeks (95% CI 238.77-318.0 weeks). Patients with complete annular calcifications had a higher all-cause 10-year mortality (femoropopliteal unadjusted HR 1.64, p = 0.04 and adjusted for age and sex HR 1.68, p = 0.04; crural unadjusted HR 1.92, p = 0.02, adjusted for age and sex HR 2.29, p = 0.006) than patients with other calcification characteristics.
Conclusions: Annularity of calcification of both femoropopliteal and crural arteries is a predictor for 10-year all-cause survival, its hazard being even higher than the traditional prognostic risk factors for CLI and therefore could be involved in the poor survival of these patients.
(Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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