Tiempo de aceleraciÓ³n plantar como factor predictivo para salvamento de extremidad

Abstract

Determinar el tiempo de aceleración plantar (PAT) como factor predictivo para salvamento de extremidad en pacientes con diagnóstico de isquemia crónica amenazadora de extremidad (CLTI). Material y método: Se realizó un estudio prospectivo, analítico y longitudinal de 2020 a 2022. Se incluyeron pacientes con diagnóstico de CLTI que cumplieran los criterios de selección. Se realizó análisis estadístico con lo descrito a la clasificación de PAT. Resultados: Se incluyeron 31 pacientes en este estudio, todos sometidos a revascularización mediante angioplastía. El salvamento de extremidad se logró en los 31 (100%). Todos cursaron con disminución del PAT a clase 1 o 2, que logró asociarse a salvamento de extremidad. Conclusiones: El estudio demostró que una disminución del PAT posterior a angioplastía se relacionó con salvamento de extremidad. Por tanto, se propone al PAT como factor predictivo para salvamento de extremidad.

Duplex ultrasound and pedal acceleration time as tools to evaluate foot perfusion: a literature review

“…These results were supported by those of a prospective cohort 11 conducted with the objective of studying PAT as a predictive factor for limb salvage in patients diagnosed with CLTI undergoing angioplasty, excluding those who had suprainguinal lesions and those who had significant infection (WIfI classes 2 and 3). At 1 year, all of the 31 patients and 31 revascularized LL had a significant reduction in PAT (mean of 213.00 ± 83.26 ms before and 118.35 ± 16.40 ms after angioplasty, p = 0.000), with no significant amputations (at or above the ankle) recorded, although 51.6% of patients (n = 16) had a minor amputation.…”

“…The search results identified 66, 12, and 1 articles from Google Scholar, PubMed, and Scielo, respectively. Of these, 36 were accessed after reading the title and keywords, 29 of which were excluded for the following reasons: reports or case series (3), no primary data on humans (11), and no relevance to the subject studied (15). In total, seven studies were selected: one retrospective cohort study, one prospective cohort study, and five cross-sectional studies, one of which one was a doctoral thesis and another of which was a specialization thesis.…”

“…This result was supported by a similar but smaller study. 11 However, none of those studies carried out a more detailed analysis of specific arteries linked to the perfusion of certain angiosomes in order to test the hypothesis that the evidence of improved flow documented by the PAT in a given artery correlates with a better response to the intervention. A third study 9 supported these findings by demonstrating a significant correlation between PAT and the amputation risk score defined using the SVS-WIfI classification.…”

“…The vast majority did not specify sample analysis or ensure that the sample studied was statistically sufficient. 4,6,8,[10][11][12] None of the studies employed randomization of data or any type of blinding methodology.…”