Mid-term outcomes of endovascular treatment and risk factors for recurrence in patients with Trans-Atlantic-Inter-Society II C/D femoropopliteal lesions

Abstract

Background: The purpose of this study was to determine the efficacy of interventional endovascular treatment (EVT) and the risk factors for postoperative restenosis in patients with Trans-Atlantic Inter-Society Consensus (TASC) II C/D femoropopliteal lesions.Methods: A total of 55 patients who received EVT for TASC Ⅱ C/D femoropopliteal lesions (64 affected limbs) from October 2014 to September 2017 were examined. The mean lesion length was 19.6±5.3 (range, 15.5-26.4 cm). The femoropopliteal lesions were classified as TASC Ⅱ C and TASC Ⅱ D in 39 and 16 cases, respectively. The ankle-brachial index (ABI), primary patency rate, secondary patency rate, and limb salvage rate were monitored in follow-up evaluations for up to 24 months. A Cox regression model was used to evaluate the correlation between each of these factors and the restenosis rate after EVT.Results: Patent TASC Ⅱ C/D femoropopliteal lesions were present in 59 of the 64 limbs. The mean ABI values for the dorsal pedal artery and posterior tibial artery increased 1 month after treatment from a baseline level of 0.35±0.12 to 0.89±0.10 and from 0.43±0.15 to 0.90±0.13, respectively (P<0.01). The mean follow-up time was 19.3 (range, 6-24) months. The cumulative primary patency rates at 1, 3, 6, 12, 18, and 24 months were 98.3%, 91.5%, 84.3%, 61.1%, 53.1%, and 31.1%, respectively. The secondary patency rates at 12 and 24 months were 70.4% and 60.0%, respectively. Factors with a high hazard ratio included male sex, TASC II D, smoking, and diabetes mellitus (DM).Conclusions: EVT had a safe and satisfactory mid-term therapeutic effect on TASC II C/D femoropopliteal lesions. Male sex, TASC II D (compared to TASC II C), smoking, and DM were risk factors for restenosis. EVT has a secondary patency rate comparable to that of open surgery and can be considered a first-line treatment for TASC II C/D femoropopliteal lesions.

Kết Quả Trung Hạn Can Thiệp Nội Mạch Tắc Động Mạch Chi Dưới Mạn Tính Trên Bệnh Nhân Đái Tháo Đường Type 2

“…Bên cạnh đó, các biểu hiện về cận lâm sàng của chúng tôi cũng cải thiện đáng kể sau can thiệp so với trước can thiệp, lần lượt chiếm 0,64 so với 0,29 mẫu nghiên cứu. Theo tác giả Lin Y và cộng sự (N=59), ghi nhận giá trị ABI cải thiện rõ rệt trước can thiệp so với sau can thiệp, 0,35 so với 0,89 (P<0,001) [6]. Còn theo Liang Xiao và cộng sự (N=139), giá trị ABI trước can thiệp so với sau can thiệp lần lượt chiếm 0,4 và 0,8 (p<0,001) [10].…”