Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia
Purpose To determine the predictive value of skin perfusion pressure (SPP) for wound healing after endovascular therapy (EVT). Methods Between May 2004 and March 2011, 113 consecutive patients (84 men; mean age 71.5±12.5 years) with CLI (123 limbs) underwent successful balloon angioplasty ± stenting...
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| Veröffentlicht in: | Journal of endovascular therapy 2014-10, Vol.21 (5), p.662-670 |
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| creator | Utsunomiya, Makoto Nakamura, Masato Nagashima, Yoshinori Sugi, Kaoru |
| description | Purpose
To determine the predictive value of skin perfusion pressure (SPP) for wound
healing after endovascular therapy (EVT).
Methods
Between May 2004 and March 2011, 113 consecutive patients (84 men; mean age
71.5±12.5 years) with CLI (123 limbs) underwent successful balloon
angioplasty ± stenting (flow from >1 vessel to the foot
without bypass) and were physically able to undergo SPP measurement before
and within 48 hours after EVT. The status of wound healing was recorded over
a mean follow-up of 17.4±12.4 months.
Results
The wound healing rate was 78.9% (97 limbs of 89 patients). SPP values
after EVT were significantly higher in these patients than in the 24
patients (26 limbs) without wound healing (44.2±15.6 mmHg vs.
27.5±10.4 mmHg, p |
| doi_str_mv | 10.1583/14-4675MR.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1609508551</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_14-4675MR.1</sage_id><sourcerecordid>1609508551</sourcerecordid><originalsourceid>FETCH-LOGICAL-c416t-f9464b3fbfc15be7b6086de4dde47a7e0c6d93f224be0c705fc26e6d4802d9cc3</originalsourceid><addsrcrecordid>eNptkUtLxDAUhYMovlfuJeBGkGqSSdJ2KcP4gBHF57KkyY1G22ZMGsF_b4fxhbi43LP4OPdwD0I7lBxSUYyOKM-4zMXF9SFdQutUcJFRIcjyXDOZScKKNbQR4zMhjDJKV9EaE6wkecnXUbgKYJzu3Rvge9UkwN7imxfX4SsINkXnBxUgxhQAH9seAp50xr-pqFOjAr59gqBm79j6gB986gw-A9W47hEPFuPgeqdVg6eurfF51E_QOrWFVqxqImx_7k10dzK5HZ9l08vT8_HxNNOcyj6zJZe8HtnaaipqyGtJCmmAm2FylQPR0pQjyxivB50TYTWTIA0vCDOl1qNNtL_wnQX_miD2VeuihqZRHfgUKypJKUghBB3QvT_os0-hG9INFCc5JzyfUwcLSgcfYwBbzYJrVXivKKnmVVSUV4sqqjm9--mZ6hbMN_v1-598UT3Cr4P_eH0Ao86Qtw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1640740471</pqid></control><display><type>article</type><title>Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia</title><source>SAGE Complete A-Z List</source><source>MEDLINE</source><creator>Utsunomiya, Makoto ; Nakamura, Masato ; Nagashima, Yoshinori ; Sugi, Kaoru</creator><creatorcontrib>Utsunomiya, Makoto ; Nakamura, Masato ; Nagashima, Yoshinori ; Sugi, Kaoru</creatorcontrib><description>Purpose
To determine the predictive value of skin perfusion pressure (SPP) for wound
healing after endovascular therapy (EVT).
Methods
Between May 2004 and March 2011, 113 consecutive patients (84 men; mean age
71.5±12.5 years) with CLI (123 limbs) underwent successful balloon
angioplasty ± stenting (flow from >1 vessel to the foot
without bypass) and were physically able to undergo SPP measurement before
and within 48 hours after EVT. The status of wound healing was recorded over
a mean follow-up of 17.4±12.4 months.
Results
The wound healing rate was 78.9% (97 limbs of 89 patients). SPP values
after EVT were significantly higher in these patients than in the 24
patients (26 limbs) without wound healing (44.2±15.6 mmHg vs.
27.5±10.4 mmHg, p<0.001). Receiver operating characteristics
analysis of SPP after EVT to predict wound healing had an area under the
curve of 0.81 (95% CI 0.723 to 0.899, p<0.001). The optimal
cutoff for predicting wound healing was 30 mmHg, with a sensitivity of
81.4% and a specificity of 69.2%. Binary logistic regression
analysis demonstrated SPP after EVT to be an independent predictor of wound
healing (p<0.001). The probability of wound healing with SPP values
>30 mmHg, 40 mmHg, and 50 mmHg were 69.8%, 86.3%, and
94.5%, respectively.
Conclusion
SPP after EVT is an independent predictor of wound healing in patients with
CLI. In our study, an SPP value of 30 mmHg was shown to be the best cutoff
for prediction of wound healing after EVT.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/14-4675MR.1</identifier><identifier>PMID: 25290794</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Age ; Aged ; Aged, 80 and over ; Amputation ; Angioplasty, Balloon - adverse effects ; Angioplasty, Balloon - instrumentation ; Ankle ; Antibiotics ; Area Under Curve ; Catheters ; Critical Illness ; Gangrene ; Heart surgery ; Humans ; Ischemia ; Ischemia - diagnosis ; Ischemia - physiopathology ; Ischemia - therapy ; Japan ; Logistic Models ; Lower Extremity - blood supply ; Male ; Microcirculation ; Middle Aged ; Mortality ; Pain ; Patients ; Predictive Value of Tests ; Regional Blood Flow ; Retrospective Studies ; ROC Curve ; Skin - blood supply ; Stents ; Time Factors ; Treatment Outcome ; Wound Healing</subject><ispartof>Journal of endovascular therapy, 2014-10, Vol.21 (5), p.662-670</ispartof><rights>2014 International Society of Endovascular Specialists</rights><rights>Copyright Allen Press Publishing Services Oct 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-f9464b3fbfc15be7b6086de4dde47a7e0c6d93f224be0c705fc26e6d4802d9cc3</citedby><cites>FETCH-LOGICAL-c416t-f9464b3fbfc15be7b6086de4dde47a7e0c6d93f224be0c705fc26e6d4802d9cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/14-4675MR.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/14-4675MR.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25290794$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Utsunomiya, Makoto</creatorcontrib><creatorcontrib>Nakamura, Masato</creatorcontrib><creatorcontrib>Nagashima, Yoshinori</creatorcontrib><creatorcontrib>Sugi, Kaoru</creatorcontrib><title>Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose
To determine the predictive value of skin perfusion pressure (SPP) for wound
healing after endovascular therapy (EVT).
Methods
Between May 2004 and March 2011, 113 consecutive patients (84 men; mean age
71.5±12.5 years) with CLI (123 limbs) underwent successful balloon
angioplasty ± stenting (flow from >1 vessel to the foot
without bypass) and were physically able to undergo SPP measurement before
and within 48 hours after EVT. The status of wound healing was recorded over
a mean follow-up of 17.4±12.4 months.
Results
The wound healing rate was 78.9% (97 limbs of 89 patients). SPP values
after EVT were significantly higher in these patients than in the 24
patients (26 limbs) without wound healing (44.2±15.6 mmHg vs.
27.5±10.4 mmHg, p<0.001). Receiver operating characteristics
analysis of SPP after EVT to predict wound healing had an area under the
curve of 0.81 (95% CI 0.723 to 0.899, p<0.001). The optimal
cutoff for predicting wound healing was 30 mmHg, with a sensitivity of
81.4% and a specificity of 69.2%. Binary logistic regression
analysis demonstrated SPP after EVT to be an independent predictor of wound
healing (p<0.001). The probability of wound healing with SPP values
>30 mmHg, 40 mmHg, and 50 mmHg were 69.8%, 86.3%, and
94.5%, respectively.
Conclusion
SPP after EVT is an independent predictor of wound healing in patients with
CLI. In our study, an SPP value of 30 mmHg was shown to be the best cutoff
for prediction of wound healing after EVT.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amputation</subject><subject>Angioplasty, Balloon - adverse effects</subject><subject>Angioplasty, Balloon - instrumentation</subject><subject>Ankle</subject><subject>Antibiotics</subject><subject>Area Under Curve</subject><subject>Catheters</subject><subject>Critical Illness</subject><subject>Gangrene</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Ischemia - diagnosis</subject><subject>Ischemia - physiopathology</subject><subject>Ischemia - therapy</subject><subject>Japan</subject><subject>Logistic Models</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Microcirculation</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pain</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Regional Blood Flow</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Skin - blood supply</subject><subject>Stents</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Wound Healing</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkUtLxDAUhYMovlfuJeBGkGqSSdJ2KcP4gBHF57KkyY1G22ZMGsF_b4fxhbi43LP4OPdwD0I7lBxSUYyOKM-4zMXF9SFdQutUcJFRIcjyXDOZScKKNbQR4zMhjDJKV9EaE6wkecnXUbgKYJzu3Rvge9UkwN7imxfX4SsINkXnBxUgxhQAH9seAp50xr-pqFOjAr59gqBm79j6gB986gw-A9W47hEPFuPgeqdVg6eurfF51E_QOrWFVqxqImx_7k10dzK5HZ9l08vT8_HxNNOcyj6zJZe8HtnaaipqyGtJCmmAm2FylQPR0pQjyxivB50TYTWTIA0vCDOl1qNNtL_wnQX_miD2VeuihqZRHfgUKypJKUghBB3QvT_os0-hG9INFCc5JzyfUwcLSgcfYwBbzYJrVXivKKnmVVSUV4sqqjm9--mZ6hbMN_v1-598UT3Cr4P_eH0Ao86Qtw</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>Utsunomiya, Makoto</creator><creator>Nakamura, Masato</creator><creator>Nagashima, Yoshinori</creator><creator>Sugi, Kaoru</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>201410</creationdate><title>Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia</title><author>Utsunomiya, Makoto ; Nakamura, Masato ; Nagashima, Yoshinori ; Sugi, Kaoru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-f9464b3fbfc15be7b6086de4dde47a7e0c6d93f224be0c705fc26e6d4802d9cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amputation</topic><topic>Angioplasty, Balloon - adverse effects</topic><topic>Angioplasty, Balloon - instrumentation</topic><topic>Ankle</topic><topic>Antibiotics</topic><topic>Area Under Curve</topic><topic>Catheters</topic><topic>Critical Illness</topic><topic>Gangrene</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Ischemia - diagnosis</topic><topic>Ischemia - physiopathology</topic><topic>Ischemia - therapy</topic><topic>Japan</topic><topic>Logistic Models</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Microcirculation</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pain</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Regional Blood Flow</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Skin - blood supply</topic><topic>Stents</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Utsunomiya, Makoto</creatorcontrib><creatorcontrib>Nakamura, Masato</creatorcontrib><creatorcontrib>Nagashima, Yoshinori</creatorcontrib><creatorcontrib>Sugi, Kaoru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Utsunomiya, Makoto</au><au>Nakamura, Masato</au><au>Nagashima, Yoshinori</au><au>Sugi, Kaoru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2014-10</date><risdate>2014</risdate><volume>21</volume><issue>5</issue><spage>662</spage><epage>670</epage><pages>662-670</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose
To determine the predictive value of skin perfusion pressure (SPP) for wound
healing after endovascular therapy (EVT).
Methods
Between May 2004 and March 2011, 113 consecutive patients (84 men; mean age
71.5±12.5 years) with CLI (123 limbs) underwent successful balloon
angioplasty ± stenting (flow from >1 vessel to the foot
without bypass) and were physically able to undergo SPP measurement before
and within 48 hours after EVT. The status of wound healing was recorded over
a mean follow-up of 17.4±12.4 months.
Results
The wound healing rate was 78.9% (97 limbs of 89 patients). SPP values
after EVT were significantly higher in these patients than in the 24
patients (26 limbs) without wound healing (44.2±15.6 mmHg vs.
27.5±10.4 mmHg, p<0.001). Receiver operating characteristics
analysis of SPP after EVT to predict wound healing had an area under the
curve of 0.81 (95% CI 0.723 to 0.899, p<0.001). The optimal
cutoff for predicting wound healing was 30 mmHg, with a sensitivity of
81.4% and a specificity of 69.2%. Binary logistic regression
analysis demonstrated SPP after EVT to be an independent predictor of wound
healing (p<0.001). The probability of wound healing with SPP values
>30 mmHg, 40 mmHg, and 50 mmHg were 69.8%, 86.3%, and
94.5%, respectively.
Conclusion
SPP after EVT is an independent predictor of wound healing in patients with
CLI. In our study, an SPP value of 30 mmHg was shown to be the best cutoff
for prediction of wound healing after EVT.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25290794</pmid><doi>10.1583/14-4675MR.1</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1526-6028 |
| ispartof | Journal of endovascular therapy, 2014-10, Vol.21 (5), p.662-670 |
| issn | 1526-6028 1545-1550 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1609508551 |
| source | SAGE Complete A-Z List; MEDLINE |
| subjects | Age Aged Aged, 80 and over Amputation Angioplasty, Balloon - adverse effects Angioplasty, Balloon - instrumentation Ankle Antibiotics Area Under Curve Catheters Critical Illness Gangrene Heart surgery Humans Ischemia Ischemia - diagnosis Ischemia - physiopathology Ischemia - therapy Japan Logistic Models Lower Extremity - blood supply Male Microcirculation Middle Aged Mortality Pain Patients Predictive Value of Tests Regional Blood Flow Retrospective Studies ROC Curve Skin - blood supply Stents Time Factors Treatment Outcome Wound Healing |
| title | Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia |
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