Subintimal angioplasty: predictors of long-term success.

Hdl Handle:
http://hdl.handle.net/10147/127492
Title:
Subintimal angioplasty: predictors of long-term success.
Authors:
Keeling, Aoife N; Khalidi, Karim; Leong, Sum; Given, Mark F; McGrath, Frank P; Athanasiou, Thanos; Lee, Michael J
Affiliation:
Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
Citation:
Subintimal angioplasty: predictors of long-term success. 2009, 20 (8):1013-22 J Vasc Interv Radiol
Journal:
Journal of vascular and interventional radiology : JVIR
Issue Date:
Aug-2009
URI:
http://hdl.handle.net/10147/127492
DOI:
10.1016/j.jvir.2009.05.005
PubMed ID:
19647180
Abstract:
To determine the clinical outcomes and success rates after percutaneous subintimal angioplasty (SIA) in patients with lower-limb occlusive lesions causing intermittent claudication (IC) or critical limb ischemia (CLI) at midterm to long-term follow-up. The secondary aim was to elicit factors predictive of a successful outcome.; Between January 1999 and June 2006, 75 consecutive patients (45 men; age range, 46-91 years; CLI in 79%) underwent SIA of iliac and infrainguinal (84%) occlusions. Outcomes were determined on an intent-to-treat basis. The composite endpoint of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up, which was defined as the development of IC, CLI, or need for subsequent endovascular or surgical revascularization. Actuarial freedom from MACO was assessed via Kaplan-Meier curves and multivariable Cox proportional-hazards regression.; SIA was performed on 75 lesions, with an initial procedure success rate of 83% (n = 62). Procedure failure was caused by heavily calcified lesions (n = 5) and failure of reentry (n = 8). A total of 56.3% of patients with claudication were free from ipsilateral claudication at follow-up (mean, 32 months; range, 1-64 months), and those with CLI had a 79.7% limb salvage rate at a mean follow-up of 30.7 months (range, 0.5-91 months). On Cox regression analysis, the following variables were identified as independent predictors of MACO within the limb treated with SIA: ABI after SIA (hazard ratio, 0.21; 95% CI, 0.05-0.89; P = .035) and number of patent runoff vessels (ie, </=1 vs >/=2; hazard ratio, 0.29; 95% CI, 0.15-0.59; P = .001).; SIA is a feasible therapeutic option for occlusive atherosclerotic lesions in IC and CLI and is the evolving preferred strategy in CLI and perhaps IC with long-segment occlusions.
Item Type:
Article
Language:
en
MeSH:
Aged; Aged, 80 and over; Angioplasty; Female; Humans; Intermittent Claudication; Ischemia; Leg; Longitudinal Studies; Male; Middle Aged; Peripheral Vascular Diseases; Treatment Outcome
ISSN:
1535-7732

Full metadata record

DC FieldValue Language
dc.contributor.authorKeeling, Aoife Nen
dc.contributor.authorKhalidi, Karimen
dc.contributor.authorLeong, Sumen
dc.contributor.authorGiven, Mark Fen
dc.contributor.authorMcGrath, Frank Pen
dc.contributor.authorAthanasiou, Thanosen
dc.contributor.authorLee, Michael Jen
dc.date.accessioned2011-04-06T14:37:18Z-
dc.date.available2011-04-06T14:37:18Z-
dc.date.issued2009-08-
dc.identifier.citationSubintimal angioplasty: predictors of long-term success. 2009, 20 (8):1013-22 J Vasc Interv Radiolen
dc.identifier.issn1535-7732-
dc.identifier.pmid19647180-
dc.identifier.doi10.1016/j.jvir.2009.05.005-
dc.identifier.urihttp://hdl.handle.net/10147/127492-
dc.description.abstractTo determine the clinical outcomes and success rates after percutaneous subintimal angioplasty (SIA) in patients with lower-limb occlusive lesions causing intermittent claudication (IC) or critical limb ischemia (CLI) at midterm to long-term follow-up. The secondary aim was to elicit factors predictive of a successful outcome.-
dc.description.abstractBetween January 1999 and June 2006, 75 consecutive patients (45 men; age range, 46-91 years; CLI in 79%) underwent SIA of iliac and infrainguinal (84%) occlusions. Outcomes were determined on an intent-to-treat basis. The composite endpoint of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up, which was defined as the development of IC, CLI, or need for subsequent endovascular or surgical revascularization. Actuarial freedom from MACO was assessed via Kaplan-Meier curves and multivariable Cox proportional-hazards regression.-
dc.description.abstractSIA was performed on 75 lesions, with an initial procedure success rate of 83% (n = 62). Procedure failure was caused by heavily calcified lesions (n = 5) and failure of reentry (n = 8). A total of 56.3% of patients with claudication were free from ipsilateral claudication at follow-up (mean, 32 months; range, 1-64 months), and those with CLI had a 79.7% limb salvage rate at a mean follow-up of 30.7 months (range, 0.5-91 months). On Cox regression analysis, the following variables were identified as independent predictors of MACO within the limb treated with SIA: ABI after SIA (hazard ratio, 0.21; 95% CI, 0.05-0.89; P = .035) and number of patent runoff vessels (ie, </=1 vs >/=2; hazard ratio, 0.29; 95% CI, 0.15-0.59; P = .001).-
dc.description.abstractSIA is a feasible therapeutic option for occlusive atherosclerotic lesions in IC and CLI and is the evolving preferred strategy in CLI and perhaps IC with long-segment occlusions.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAngioplasty-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIntermittent Claudication-
dc.subject.meshIschemia-
dc.subject.meshLeg-
dc.subject.meshLongitudinal Studies-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPeripheral Vascular Diseases-
dc.subject.meshTreatment Outcome-
dc.titleSubintimal angioplasty: predictors of long-term success.en
dc.typeArticleen
dc.contributor.departmentDepartment of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.en
dc.identifier.journalJournal of vascular and interventional radiology : JVIRen
dc.description.provinceLeinster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.