Clinically-driven need for secondary interventions after endovascular revascularization of tibial arteries in patients with critical limb ischemia

Baumann, Frederic; Bloesch, Stephan; Engelberger, Rolf Peter; Makaloski, Vladimir; Fink, Hanspeter; Do, Dai-Do; Baumgartner, Iris; Diehm, Nicolas Alexander (2013). Clinically-driven need for secondary interventions after endovascular revascularization of tibial arteries in patients with critical limb ischemia. Journal of endovascular therapy, 20(5), pp. 707-13. International Society of Endovascular Specialists 10.1583/13-4375MR.1

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PURPOSE To assess the need for clinically-driven secondary revascularization in critical limb ischemia (CLI) patients subsequent to tibial angioplasty during a 2-year follow-up. METHODS Between 2008 and 2010, a total of 128 consecutive CLI patients (80 men; mean age 76.5±9.8 years) underwent tibial angioplasty in 139 limbs. Rutherford categories, ankle-brachial index measurements, and lower limb oscillometries were prospectively assessed. All patients were followed at 3, 6, 12 months, and annually thereafter. Rates of death, primary and secondary sustained clinical improvement, target lesion (TLR) and target extremity revascularization (TER), as well as major amputation, were analyzed retrospectively. Primary clinical improvement was defined as improvement in Rutherford category to a level of intermittent claudication without unplanned amputation or TLR. RESULTS All-cause mortality was 8.6%, 14.8%, 22.9%, and 29.1% at 3, 6, 12, and 24 months. At the same intervals, rates of primary sustained clinical improvement were 74.5%, 53.0%, 42.7%, and 37.1%; for secondary improvement, the rates were 89.1%, 76.0%, 68.4%, and 65.0%. Clinically-driven TLR rates were 14.6%, 29.1%, 41.6%, 46.2%; the rates for TER were 3.0%, 13.6%, 17.2%, and 27.6% in corresponding intervals, while the rates of major amputation were 1.5%, 5.5%, 10.1%, and 10.1%. CONCLUSION Clinically-driven TLR is frequently required to maintain favorable functional clinical outcomes in CLI patients following tibial angioplasty. Dedicated technologies addressing tibial arterial restenosis warrant further academic scrutiny.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Baumann, Frederic; Baumgartner, Iris and Diehm, Nicolas Alexander

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1526-6028

Publisher:

International Society of Endovascular Specialists

Language:

English

Submitter:

Patricia Rajaonina

Date Deposited:

28 Mar 2014 15:31

Last Modified:

17 Jul 2014 12:13

Publisher DOI:

10.1583/13-4375MR.1

PubMed ID:

24093325

URI:

https://boris.unibe.ch/id/eprint/44392

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