| Autor: |
Kokkinidis DG; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT 06510, USA., Schizas D; First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece., Pargaonkar S; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA., Karamanis D; Department of Economics, University of Piraeus, 18534 Piraeus, Greece.; Department of Health Informatics, Rutgers School of Health Professions, Newark, NJ 07107, USA., Mylonas KS; First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece., Hasemaki N; First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece., Palaiodimos L; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA., Varrias D; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA., Tzavellas G; Department of Vascular Surgery, Ball Memorial Hospital, Muncie, IN 47303, USA., Siasos G; 3rd Department of Cardiology, Sotiria General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece., Klonaris C; First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece., Kharawala A; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA., Chlorogiannis DD; Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA., Georgopoulos S; First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece., Bakoyiannis C; Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA. |
| Abstrakt: |
Background and Objectives: In patients with peripheral artery disease, there is insufficient understanding of characteristics that predict successful revascularization of the lower extremity (LE) chronic total occlusions (CTOs) and baseline differences in demographic, clinical, and angiographic characteristics in patients with LE CTO vs. non-CTO. We aim to explore these differences and predictors of successful revascularization among CTO patients. Materials and Methods: Two vascular centers enrolled LE-CTO patients who underwent endovascular revascularization. Data on demographics, clinical, angiographic, and interventional characteristics were collected. LE non-CTO arterial stenosis patients were compared. A total of 256 patients with LE revascularization procedures were studied; among them, 120 had CTOs and 136 had LE stenosis but no CTOs. Results: Aspirin use (Odds ratio, OR: 3.43; CI 1.32-8.88; p = 0.011) was a positive predictor whereas a history of malignancy (OR: 0.27; CI 0.09-0.80; p = 0.018) was a negative predictor of successful crossing in the CTO group. The CTO group had a higher history of myocardial infarction (29.2 vs. 18.3%, p = 0.05), end-stage renal disease (19.2 vs. 9.6%, p = 0.03), and chronic limb-threatening ischemia as the reason for revascularization (64.2 vs. 22.8%, p < 0.001). They were more likely to have advanced TransAtlantic Inter-Society Consensus (TASC) stages, multi-vessel revascularization procedures, longer lesions, and urgent treatment. Conclusions: The use of aspirin is a positive predictor whereas a history of malignancy is a negative predictor for successful crossing in CTO lesions. Additionally, LE-CTO patients have a higher incidence of comorbidities, which is expected given their higher disease burden. Successful endovascular re-vascularization can be associated with baseline clinical variables. |
