What's Next after Optimal Infrapopliteal Angioplasty? Clinical and Ultrasonographic Results of a Prospective Single-Center Study
Purpose: To evaluate arterial patency and factors influencing outcomes after successful tibial artery angioplasty in patients with critical limb ischemia (CLI). Methods: From January 2005 to August 2007, a prospective single-center study was conducted involving 80 CLI patients (56 men; mean age 71.7...
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| Veröffentlicht in: | Journal of endovascular therapy 2008-06, Vol.15 (3), p.363-369 |
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| creator | Gargiulo, Mauro Maioli, Filippo Ceccacci, Tanja Morselli-Labate, Antonio Maria Faggioli, Gianluca Freyrie, Antonio Giovanetti, Federica Testi, Gabriele Muccini, Natascia Stella, Andrea |
| description | Purpose:
To evaluate arterial patency and factors influencing outcomes after successful tibial artery angioplasty in patients with critical limb ischemia (CLI).
Methods:
From January 2005 to August 2007, a prospective single-center study was conducted involving 80 CLI patients (56 men; mean age 71.7±8.8 years) who underwent successful tibial artery angioplasty ( |
| doi_str_mv | 10.1583/08-2423.1 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71657052</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_08-2423.1</sage_id><sourcerecordid>71657052</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-4a7cf4d111d8537634ae6785edbda3bedfa6aceb0f1894e89b13d95196cb0b4f3</originalsourceid><addsrcrecordid>eNplkU1v1DAQhi0Eoh9w4A8giwMVhxRPYifOCVUrPipVFFEqjpYTj7euvE5qO4i98dPxqiutBKeZsR6983peQl4BOwchm_dMVjWvm3N4Qo5BcFGBEOzprq_bqmW1PCInKd0zVkMN8JwcgRScdaw_Jn9-3ul8luhX_J2pthkjvZ6z22hPL4ONep5m7zKW8SKsXRl0ytsPdOVdcGN51cHQW5-jTlOY1oW_cyP9jmnxOdHJUk2_xSnNOGb3C-mNC2uP1QrDbtFNXsz2BXlmtU_4cl9Pye2njz9WX6qr68-Xq4uraixOc8V1N1puAMBI0XRtwzW2nRRoBqObAY3VrR5xYBZkz1H2AzSmF9C348AGbptT8vZRd47Tw4Ipq41LI3qvA05LUh20omOiLuCbf8D7aYmheFPleNB0grcFevcIjeV3KaJVcyxHi1sFTO0yUUyqXSYKCvt6L7gMGzQHch_CwVrSazxs-1_pL6Y9lAA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211137546</pqid></control><display><type>article</type><title>What's Next after Optimal Infrapopliteal Angioplasty? Clinical and Ultrasonographic Results of a Prospective Single-Center Study</title><source>MEDLINE</source><source>SAGE Complete</source><source>Alma/SFX Local Collection</source><creator>Gargiulo, Mauro ; Maioli, Filippo ; Ceccacci, Tanja ; Morselli-Labate, Antonio Maria ; Faggioli, Gianluca ; Freyrie, Antonio ; Giovanetti, Federica ; Testi, Gabriele ; Muccini, Natascia ; Stella, Andrea</creator><creatorcontrib>Gargiulo, Mauro ; Maioli, Filippo ; Ceccacci, Tanja ; Morselli-Labate, Antonio Maria ; Faggioli, Gianluca ; Freyrie, Antonio ; Giovanetti, Federica ; Testi, Gabriele ; Muccini, Natascia ; Stella, Andrea</creatorcontrib><description>Purpose:
To evaluate arterial patency and factors influencing outcomes after successful tibial artery angioplasty in patients with critical limb ischemia (CLI).
Methods:
From January 2005 to August 2007, a prospective single-center study was conducted involving 80 CLI patients (56 men; mean age 71.7±8.8 years) who underwent successful tibial artery angioplasty (<30% residual stenosis) in 87 limbs. Eighty (92%) limbs showed ischemic ulcers or gangrene at baseline. In two thirds, a more proximal lesion was treated, and a secondary stent was implanted in 14 (16%). Follow-up included clinical examination for wound healing (WH), limb salvage (LS), and duplex-documented target vessel patency or restenosis at discharge and at 1, 3, 6, 9, 12, 18, and then every 6 months. Patency rates, WH, and LS were assessed with the Kaplan-Meier method, and factors influencing these outcomes were analyzed using Cox proportional hazards models.
Results:
Mean follow-up was 10.9 months (range 2 days — 29 months). At 12 months, the primary and assisted primary patency rates were 37.9% and 71.2%, respectively. Restenosis was significantly correlated with smoking (HR 3.58, 95% CI 1.15 to 11.18; p=0.02), infected ulcers (HR 2.04, 95% CI 1.02 to 4.09; p=0.04), and posterior tibial artery angioplasty (HR 3.76, 95% CI 1.59 to 8.87; p=0.003). Rates of LS and WH at 12 months were 92.7% and 74.9%, respectively. Peroneal angioplasty was significantly correlated with WH (HR 1.83, 95% CI 1.04 to 3.25; p=0.03), and wound healing increased with classes of age (HR 1.60, 95% CI 1.07 to 2.39; p=0.02).
Conclusion:
One-year restenosis after optimal tibial artery angioplasty is significant and positively correlated with smoking, infection of trophic lesions, and posterior tibial artery angioplasty. Close ultrasound surveillance provides good limb salvage after optimal infrapopliteal angioplasty in patients with CLI.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/08-2423.1</identifier><identifier>PMID: 18540709</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Angioplasty, Balloon - adverse effects ; Arterial Occlusive Diseases - complications ; Arterial Occlusive Diseases - diagnostic imaging ; Arterial Occlusive Diseases - physiopathology ; Arterial Occlusive Diseases - therapy ; Awards and Prizes ; Constriction, Pathologic ; Critical Illness ; Female ; Humans ; Ischemia - diagnostic imaging ; Ischemia - etiology ; Ischemia - physiopathology ; Ischemia - therapy ; Limb Salvage ; Lower Extremity - blood supply ; Male ; Medical imaging ; Patients ; Proportional Hazards Models ; Prospective Studies ; Recurrence ; Risk Assessment ; Risk Factors ; Smoking - adverse effects ; Studies ; Success ; Tibial Arteries - diagnostic imaging ; Tibial Arteries - physiopathology ; Time Factors ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Vascular Patency ; Vein & artery diseases ; Wound Healing ; Wound Infection - complications</subject><ispartof>Journal of endovascular therapy, 2008-06, Vol.15 (3), p.363-369</ispartof><rights>2008 SAGE Publications</rights><rights>Copyright Alliance Communications Group, A Division of Allen Press, Inc. Jun 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-4a7cf4d111d8537634ae6785edbda3bedfa6aceb0f1894e89b13d95196cb0b4f3</citedby><cites>FETCH-LOGICAL-c407t-4a7cf4d111d8537634ae6785edbda3bedfa6aceb0f1894e89b13d95196cb0b4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/08-2423.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/08-2423.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18540709$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gargiulo, Mauro</creatorcontrib><creatorcontrib>Maioli, Filippo</creatorcontrib><creatorcontrib>Ceccacci, Tanja</creatorcontrib><creatorcontrib>Morselli-Labate, Antonio Maria</creatorcontrib><creatorcontrib>Faggioli, Gianluca</creatorcontrib><creatorcontrib>Freyrie, Antonio</creatorcontrib><creatorcontrib>Giovanetti, Federica</creatorcontrib><creatorcontrib>Testi, Gabriele</creatorcontrib><creatorcontrib>Muccini, Natascia</creatorcontrib><creatorcontrib>Stella, Andrea</creatorcontrib><title>What's Next after Optimal Infrapopliteal Angioplasty? Clinical and Ultrasonographic Results of a Prospective Single-Center Study</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To evaluate arterial patency and factors influencing outcomes after successful tibial artery angioplasty in patients with critical limb ischemia (CLI).
Methods:
From January 2005 to August 2007, a prospective single-center study was conducted involving 80 CLI patients (56 men; mean age 71.7±8.8 years) who underwent successful tibial artery angioplasty (<30% residual stenosis) in 87 limbs. Eighty (92%) limbs showed ischemic ulcers or gangrene at baseline. In two thirds, a more proximal lesion was treated, and a secondary stent was implanted in 14 (16%). Follow-up included clinical examination for wound healing (WH), limb salvage (LS), and duplex-documented target vessel patency or restenosis at discharge and at 1, 3, 6, 9, 12, 18, and then every 6 months. Patency rates, WH, and LS were assessed with the Kaplan-Meier method, and factors influencing these outcomes were analyzed using Cox proportional hazards models.
Results:
Mean follow-up was 10.9 months (range 2 days — 29 months). At 12 months, the primary and assisted primary patency rates were 37.9% and 71.2%, respectively. Restenosis was significantly correlated with smoking (HR 3.58, 95% CI 1.15 to 11.18; p=0.02), infected ulcers (HR 2.04, 95% CI 1.02 to 4.09; p=0.04), and posterior tibial artery angioplasty (HR 3.76, 95% CI 1.59 to 8.87; p=0.003). Rates of LS and WH at 12 months were 92.7% and 74.9%, respectively. Peroneal angioplasty was significantly correlated with WH (HR 1.83, 95% CI 1.04 to 3.25; p=0.03), and wound healing increased with classes of age (HR 1.60, 95% CI 1.07 to 2.39; p=0.02).
Conclusion:
One-year restenosis after optimal tibial artery angioplasty is significant and positively correlated with smoking, infection of trophic lesions, and posterior tibial artery angioplasty. Close ultrasound surveillance provides good limb salvage after optimal infrapopliteal angioplasty in patients with CLI.</description><subject>Aged</subject><subject>Angioplasty, Balloon - adverse effects</subject><subject>Arterial Occlusive Diseases - complications</subject><subject>Arterial Occlusive Diseases - diagnostic imaging</subject><subject>Arterial Occlusive Diseases - physiopathology</subject><subject>Arterial Occlusive Diseases - therapy</subject><subject>Awards and Prizes</subject><subject>Constriction, Pathologic</subject><subject>Critical Illness</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia - diagnostic imaging</subject><subject>Ischemia - etiology</subject><subject>Ischemia - physiopathology</subject><subject>Ischemia - therapy</subject><subject>Limb Salvage</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Smoking - adverse effects</subject><subject>Studies</subject><subject>Success</subject><subject>Tibial Arteries - diagnostic imaging</subject><subject>Tibial Arteries - physiopathology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Doppler, Duplex</subject><subject>Vascular Patency</subject><subject>Vein & artery diseases</subject><subject>Wound Healing</subject><subject>Wound Infection - complications</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNplkU1v1DAQhi0Eoh9w4A8giwMVhxRPYifOCVUrPipVFFEqjpYTj7euvE5qO4i98dPxqiutBKeZsR6983peQl4BOwchm_dMVjWvm3N4Qo5BcFGBEOzprq_bqmW1PCInKd0zVkMN8JwcgRScdaw_Jn9-3ul8luhX_J2pthkjvZ6z22hPL4ONep5m7zKW8SKsXRl0ytsPdOVdcGN51cHQW5-jTlOY1oW_cyP9jmnxOdHJUk2_xSnNOGb3C-mNC2uP1QrDbtFNXsz2BXlmtU_4cl9Pye2njz9WX6qr68-Xq4uraixOc8V1N1puAMBI0XRtwzW2nRRoBqObAY3VrR5xYBZkz1H2AzSmF9C348AGbptT8vZRd47Tw4Ipq41LI3qvA05LUh20omOiLuCbf8D7aYmheFPleNB0grcFevcIjeV3KaJVcyxHi1sFTO0yUUyqXSYKCvt6L7gMGzQHch_CwVrSazxs-1_pL6Y9lAA</recordid><startdate>200806</startdate><enddate>200806</enddate><creator>Gargiulo, Mauro</creator><creator>Maioli, Filippo</creator><creator>Ceccacci, Tanja</creator><creator>Morselli-Labate, Antonio Maria</creator><creator>Faggioli, Gianluca</creator><creator>Freyrie, Antonio</creator><creator>Giovanetti, Federica</creator><creator>Testi, Gabriele</creator><creator>Muccini, Natascia</creator><creator>Stella, Andrea</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>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200806</creationdate><title>What's Next after Optimal Infrapopliteal Angioplasty? Clinical and Ultrasonographic Results of a Prospective Single-Center Study</title><author>Gargiulo, Mauro ; Maioli, Filippo ; Ceccacci, Tanja ; Morselli-Labate, Antonio Maria ; Faggioli, Gianluca ; Freyrie, Antonio ; Giovanetti, Federica ; Testi, Gabriele ; Muccini, Natascia ; Stella, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-4a7cf4d111d8537634ae6785edbda3bedfa6aceb0f1894e89b13d95196cb0b4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Angioplasty, Balloon - adverse effects</topic><topic>Arterial Occlusive Diseases - complications</topic><topic>Arterial Occlusive Diseases - diagnostic imaging</topic><topic>Arterial Occlusive Diseases - physiopathology</topic><topic>Arterial Occlusive Diseases - therapy</topic><topic>Awards and Prizes</topic><topic>Constriction, Pathologic</topic><topic>Critical Illness</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia - diagnostic imaging</topic><topic>Ischemia - etiology</topic><topic>Ischemia - physiopathology</topic><topic>Ischemia - therapy</topic><topic>Limb Salvage</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Smoking - adverse effects</topic><topic>Studies</topic><topic>Success</topic><topic>Tibial Arteries - diagnostic imaging</topic><topic>Tibial Arteries - physiopathology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Doppler, Duplex</topic><topic>Vascular Patency</topic><topic>Vein & artery diseases</topic><topic>Wound Healing</topic><topic>Wound Infection - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gargiulo, Mauro</creatorcontrib><creatorcontrib>Maioli, Filippo</creatorcontrib><creatorcontrib>Ceccacci, Tanja</creatorcontrib><creatorcontrib>Morselli-Labate, Antonio Maria</creatorcontrib><creatorcontrib>Faggioli, Gianluca</creatorcontrib><creatorcontrib>Freyrie, Antonio</creatorcontrib><creatorcontrib>Giovanetti, Federica</creatorcontrib><creatorcontrib>Testi, Gabriele</creatorcontrib><creatorcontrib>Muccini, Natascia</creatorcontrib><creatorcontrib>Stella, Andrea</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>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gargiulo, Mauro</au><au>Maioli, Filippo</au><au>Ceccacci, Tanja</au><au>Morselli-Labate, Antonio Maria</au><au>Faggioli, Gianluca</au><au>Freyrie, Antonio</au><au>Giovanetti, Federica</au><au>Testi, Gabriele</au><au>Muccini, Natascia</au><au>Stella, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What's Next after Optimal Infrapopliteal Angioplasty? Clinical and Ultrasonographic Results of a Prospective Single-Center Study</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2008-06</date><risdate>2008</risdate><volume>15</volume><issue>3</issue><spage>363</spage><epage>369</epage><pages>363-369</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To evaluate arterial patency and factors influencing outcomes after successful tibial artery angioplasty in patients with critical limb ischemia (CLI).
Methods:
From January 2005 to August 2007, a prospective single-center study was conducted involving 80 CLI patients (56 men; mean age 71.7±8.8 years) who underwent successful tibial artery angioplasty (<30% residual stenosis) in 87 limbs. Eighty (92%) limbs showed ischemic ulcers or gangrene at baseline. In two thirds, a more proximal lesion was treated, and a secondary stent was implanted in 14 (16%). Follow-up included clinical examination for wound healing (WH), limb salvage (LS), and duplex-documented target vessel patency or restenosis at discharge and at 1, 3, 6, 9, 12, 18, and then every 6 months. Patency rates, WH, and LS were assessed with the Kaplan-Meier method, and factors influencing these outcomes were analyzed using Cox proportional hazards models.
Results:
Mean follow-up was 10.9 months (range 2 days — 29 months). At 12 months, the primary and assisted primary patency rates were 37.9% and 71.2%, respectively. Restenosis was significantly correlated with smoking (HR 3.58, 95% CI 1.15 to 11.18; p=0.02), infected ulcers (HR 2.04, 95% CI 1.02 to 4.09; p=0.04), and posterior tibial artery angioplasty (HR 3.76, 95% CI 1.59 to 8.87; p=0.003). Rates of LS and WH at 12 months were 92.7% and 74.9%, respectively. Peroneal angioplasty was significantly correlated with WH (HR 1.83, 95% CI 1.04 to 3.25; p=0.03), and wound healing increased with classes of age (HR 1.60, 95% CI 1.07 to 2.39; p=0.02).
Conclusion:
One-year restenosis after optimal tibial artery angioplasty is significant and positively correlated with smoking, infection of trophic lesions, and posterior tibial artery angioplasty. Close ultrasound surveillance provides good limb salvage after optimal infrapopliteal angioplasty in patients with CLI.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>18540709</pmid><doi>10.1583/08-2423.1</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Angioplasty, Balloon - adverse effects Arterial Occlusive Diseases - complications Arterial Occlusive Diseases - diagnostic imaging Arterial Occlusive Diseases - physiopathology Arterial Occlusive Diseases - therapy Awards and Prizes Constriction, Pathologic Critical Illness Female Humans Ischemia - diagnostic imaging Ischemia - etiology Ischemia - physiopathology Ischemia - therapy Limb Salvage Lower Extremity - blood supply Male Medical imaging Patients Proportional Hazards Models Prospective Studies Recurrence Risk Assessment Risk Factors Smoking - adverse effects Studies Success Tibial Arteries - diagnostic imaging Tibial Arteries - physiopathology Time Factors Treatment Outcome Ultrasonography, Doppler, Duplex Vascular Patency Vein & artery diseases Wound Healing Wound Infection - complications |
| title | What's Next after Optimal Infrapopliteal Angioplasty? Clinical and Ultrasonographic Results of a Prospective Single-Center Study |
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