Perioperative Complications After Aorto-iliac Stenting: Associated Factors and Impact on Follow-up Cardiovascular Prognosis
Autor: | Y. Soga, Masaaki Uematsu, K. Suzuki, Yasutaka Yamauchi, Yoshiaki Shintani, Taketsugu Tsuchiya, Mitsuyoshi Takahara, Hiroki Takahashi, Junichi Tazaki, Shinya Okazaki, Yusuke Miyashita, Michiaki Higashitani, Norihiko Shinozaki, Osamu Iida, Nobuhiro Suematsu, Daizo Kawasaki, K. Hirano, Terutoshi Yamaoka, Daisuke Kamoi, Ryouji Koshida |
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Rok vydání: | 2014 |
Předmět: |
Adult
Male medicine.medical_specialty Time Factors Critical Illness Endovascular therapy Aortic Diseases Constriction Pathologic Logistic regression Iliac Artery Risk Assessment Peripheral Arterial Disease Japan Ischemia Risk Factors Internal medicine Odds Ratio Stent medicine Humans Aged Proportional Hazards Models Retrospective Studies Medicine(all) Aged 80 and over Perioperative complications Proportional hazards model business.industry Hazard ratio Age Factors Aorto-iliac occlusive disease Retrospective cohort study Critical limb ischemia Perioperative Odds ratio Middle Aged Confidence interval Surgery Radiography Logistic Models Treatment Outcome Multivariate Analysis Female Stents medicine.symptom Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
Zdroj: | European Journal of Vascular and Endovascular Surgery. 47:131-138 |
ISSN: | 1078-5884 |
Popis: | Objectives To investigate factors associated with 30-day perioperative complications (POC) after aorto-iliac (AI) stenting, and to compare follow-up cardiovascular prognosis between patients with and without POC. Materials and methods This was a retrospective multicenter study. We used a multicenter database of 2012 consecutive patients who successfully underwent AI stenting for peripheral arterial disease in 18 centers in Japan from January 2005 to December 2009 to analyze independent predictors of POC and impact of POC on prognosis by logistic regression and a Cox proportional hazard regression model, respectively. Results Mean age was 71 ± 9 years (median: 72 years; range: 37–98 years), and 1,636 patients (81%) were men. POC occurred in 126 patients (6.3%). In multivariate logistic regression analysis, old age (≥80 years), critical limb ischemia (CLI), and Trans Atlantic Inter-Societal Consensus (TASC) II class C/D were independently associated with POC with adjusted odds ratios and 95% confidence intervals (CI) of 1.9 (1.3–2.9), 2.3 (1.5–3.4), and 2.4 (1.6–3.4), respectively. Out of 2012 patients, 1995 were followed up for more than 30 days (mean: 2.6 ± 1.5 years; range: 2–2,393 days). In a Cox hazard regression model adjusted for baseline clinical characteristics, POC was positively and independently associated with follow-up major adverse cardiac events (adjusted hazard ratio [HR]: 1.9; 95% CI: 1.3–2.8; p = .002), but not with major adverse limb events and target lesion revascularization (adjusted HR: 1.4; 95% CI: 0.7–2.7; p = .25; and adjusted HR: 1.2; 95% CI 0.6–2.6; p = .568), respectively. Conclusions Age >80 years, CLI, and TASC C/D lesion were positively associated with POC after AI stenting. Occurrence of POC appears to adversely affect follow-up cardiovascular, but not limb and vessel prognosis. |
Databáze: | OpenAIRE |
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