Long-Term Results of Treatment for Critical Limb Ischemia - PubMed (original) (raw)

doi: 10.3400/avd.oa.15-00074. Epub 2015 Aug 7.

Masamitsu Suhara 1, Yoko Nemoto 1, Takuro Shirasu 1, Makoto Haga 1, Yasuaki Mochizuki 1, Mitsuru Matsukura 1, Takafumi Akai 1, Ryosuke Taniguchi 1, Masaru Nemoto 1, Satoshi Yamamoto 1, Ayako Nishiyama 1, Akihiro Hosaka 1, Katsuyuki Hoshina 1, Hiroyuki Okamoto 1, Kunihiro Shigematsu 1, Tetsuro Miyata 2, Toshiaki Watanabe 3

Affiliations

• PMID: 26421066
• PMCID: PMC4575329
• DOI: 10.3400/avd.oa.15-00074

Long-Term Results of Treatment for Critical Limb Ischemia

Takuya Miyahara et al. Ann Vasc Dis. 2015.

Abstract

From 2001 to 2012, arterial reconstruction was performed in 306 out of 497 limbs (62%) with critical limb ischemia. The reasons for non-vascularization include high operative risk (36%), extended necrosis or infection (20%), and technical issues (15%). Cumulative patency and limb salvage in collagen disease were significantly worse compared to arteriosclerosis obliterans. Cumulative limb salvage, amputation free survival (AFS), and major adverse limb event and perioperative death (MALE + POD) in patients with end-stage renal disease (ESRD) were significantly worse compared to patients without ESRD, but not significant with regards to graft patency. Our finding suggests that aggressive arterial reconstruction provides satisfactory long-term results in critical limb ischemia so long as case selection for revascularization is properly made. (This article is a translation of J Jpn Coll Angiol 2014; 54: 5-11.).

Keywords: arterial reconstruction; arteriosclerosis obliterans; critical limb ischemia; peripheral arterial disease.

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Figures

Fig. 1

Early results of critical limb ischemia after revascularization. NOMI: non-occlusive mesenteric ischemia; PE: pulmonary embolism

Fig. 2

Long-term results of critical limb ischemia after revascularization.

Fig. 3

Cumulative limb salvage rate in critical limb ischemia due to ASO after arterial reconstruction (P <0.041, log-rank test, ASO vs Collagen). Dotted lines represent limb salvage estimates when standard error exceeds 10%. ASO: arteriosclerosis obliterans; TAO: thromboangiitis obliterans

Fig. 4

Cumulative limb salvage rate in critical limb ischemia due to ASO after arterial reconstruction (P <0.0001, log-rank test). Dotted lines represent limb salvage estimates when standard error exceeds 10%. ESRD: end-stage renal disease; ASO: arteriosclerosis obliterans

Fig. 5

Cumulative primary patency rate in critical limb ischemia due to ASO after distal bypass (P = 0.379, log-rank test). Dotted lines represent primary patency estimates when standard error exceeds 10%. ESRD: end-stage renal disease; ASO: arteriosclerosis obliterans

Fig. 6

Cumulative secondary patency rate in critical limb ischemia due to ASO after distal bypass (P = 0.091, log-rank test). ESRD: end-stage renal disease; ASO: arteriosclerosis obliterans

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