Below knee angioplasty in elderly patients: predictors of major adverse clinical outcomes.

Hdl Handle:
http://hdl.handle.net/10147/207269
Title:
Below knee angioplasty in elderly patients: predictors of major adverse clinical outcomes.
Authors:
Keeling, Aoife N; Khalidi, Karim; Leong, Sum; Wang, Tim T; Ayyoub, Alaa S; McGrath, Frank P; Athanasiou, Thanos; Lee, Michael J
Affiliation:
Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9,, Ireland.
Citation:
Eur J Radiol. 2011 Mar;77(3):483-9. Epub 2009 Sep 17.
Journal:
European journal of radiology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207269
DOI:
10.1016/j.ejrad.2009.08.011
PubMed ID:
19765932
Abstract:
AIM: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). MATERIALS AND METHODS: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. RESULTS: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). CONCLUSION: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.
Language:
eng
MeSH:
Aged; Amputation/*utilization; Angioplasty/*statistics & numerical data; Atherosclerosis/*epidemiology; Female; Great Britain/epidemiology; Humans; Intermittent Claudication/*surgery; Ischemia/*epidemiology; Leg Ulcer/*epidemiology; Male; Middle Aged; Prevalence; Risk Assessment; Risk Factors; Treatment Outcome
ISSN:
1872-7727 (Electronic); 0720-048X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKeeling, Aoife Nen_GB
dc.contributor.authorKhalidi, Karimen_GB
dc.contributor.authorLeong, Sumen_GB
dc.contributor.authorWang, Tim Ten_GB
dc.contributor.authorAyyoub, Alaa Sen_GB
dc.contributor.authorMcGrath, Frank Pen_GB
dc.contributor.authorAthanasiou, Thanosen_GB
dc.contributor.authorLee, Michael Jen_GB
dc.date.accessioned2012-02-01T10:03:37Z-
dc.date.available2012-02-01T10:03:37Z-
dc.date.issued2012-02-01T10:03:37Z-
dc.identifier.citationEur J Radiol. 2011 Mar;77(3):483-9. Epub 2009 Sep 17.en_GB
dc.identifier.issn1872-7727 (Electronic)en_GB
dc.identifier.issn0720-048X (Linking)en_GB
dc.identifier.pmid19765932en_GB
dc.identifier.doi10.1016/j.ejrad.2009.08.011en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207269-
dc.description.abstractAIM: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). MATERIALS AND METHODS: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. RESULTS: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). CONCLUSION: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAmputation/*utilizationen_GB
dc.subject.meshAngioplasty/*statistics & numerical dataen_GB
dc.subject.meshAtherosclerosis/*epidemiologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGreat Britain/epidemiologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIntermittent Claudication/*surgeryen_GB
dc.subject.meshIschemia/*epidemiologyen_GB
dc.subject.meshLeg Ulcer/*epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshRisk Assessmenten_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.titleBelow knee angioplasty in elderly patients: predictors of major adverse clinical outcomes.en_GB
dc.contributor.departmentDepartment of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9,, Ireland.en_GB
dc.identifier.journalEuropean journal of radiologyen_GB
dc.description.provinceLeinster-

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