Early-phase wound healing and long-term outcomes of a selective endovascular-first approach for treating Rutherford 5 critical limb ischemia with infrainguinal lesions

Kentaro Inoue, Toshihiro Onohara, Keita Mikasa, Tadashi Furuyama

研究成果: ジャーナルへの寄稿記事

4 引用 (Scopus)

抄録

Purpose: To evaluate the validity of a selective endovascular-first approach for Rutherford 5 critical limb ischemia (CLI). Methods: We analyzed, retrospectively, 51 limbs in 46 patients treated for Rutherford 5 CLI with infrainguinal lesions between 2010 and 2012. Endovascular therapy (EVT) and open surgical revascularization (OSR) were performed initially in 28 and 23 limbs, respectively. The interventions were assigned according to the systemic condition and femoropopiliteal TransAtlantic Inter-Society Consensus (TASC) II classification. We investigated early wound healing rates (defined as healing within 90 days) and amputation-free survival (AFS) rates in the EVT and OSR groups. Results: The OSR group had more TASC D lesions (P < 0.0001). The early wound healing rate was significantly higher in the OSR group (OSR 46.1 % vs. EVT 14.3, P = 0.0205); however, the AFS rates did not differ significantly between the groups (P = 0.4031). Preoperative walking ability significantly influenced AFS (P < 0.0001). Conclusions: Our selective endovascular-first approach did not worsen AFS; however, OSR yielded better early wound healing rates. Preoperative walking ability strongly influenced AFS; hence, patients with good walking ability were good candidates for primary OSR. The indications for EVT for earlier wound healing still require better clarification.

元の言語英語
ページ(範囲)1301-1309
ページ数9
ジャーナルSurgery today
46
発行部数11
DOI
出版物ステータス出版済み - 11 1 2016

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Amputation
Wound Healing
Ischemia
Extremities
Walking
Survival
Survival Rate
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

これを引用

Early-phase wound healing and long-term outcomes of a selective endovascular-first approach for treating Rutherford 5 critical limb ischemia with infrainguinal lesions. / Inoue, Kentaro; Onohara, Toshihiro; Mikasa, Keita; Furuyama, Tadashi.

:: Surgery today, 巻 46, 番号 11, 01.11.2016, p. 1301-1309.

研究成果: ジャーナルへの寄稿記事

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abstract = "Purpose: To evaluate the validity of a selective endovascular-first approach for Rutherford 5 critical limb ischemia (CLI). Methods: We analyzed, retrospectively, 51 limbs in 46 patients treated for Rutherford 5 CLI with infrainguinal lesions between 2010 and 2012. Endovascular therapy (EVT) and open surgical revascularization (OSR) were performed initially in 28 and 23 limbs, respectively. The interventions were assigned according to the systemic condition and femoropopiliteal TransAtlantic Inter-Society Consensus (TASC) II classification. We investigated early wound healing rates (defined as healing within 90 days) and amputation-free survival (AFS) rates in the EVT and OSR groups. Results: The OSR group had more TASC D lesions (P < 0.0001). The early wound healing rate was significantly higher in the OSR group (OSR 46.1 {\%} vs. EVT 14.3, P = 0.0205); however, the AFS rates did not differ significantly between the groups (P = 0.4031). Preoperative walking ability significantly influenced AFS (P < 0.0001). Conclusions: Our selective endovascular-first approach did not worsen AFS; however, OSR yielded better early wound healing rates. Preoperative walking ability strongly influenced AFS; hence, patients with good walking ability were good candidates for primary OSR. The indications for EVT for earlier wound healing still require better clarification.",
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T1 - Early-phase wound healing and long-term outcomes of a selective endovascular-first approach for treating Rutherford 5 critical limb ischemia with infrainguinal lesions

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AU - Onohara, Toshihiro

AU - Mikasa, Keita

AU - Furuyama, Tadashi

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N2 - Purpose: To evaluate the validity of a selective endovascular-first approach for Rutherford 5 critical limb ischemia (CLI). Methods: We analyzed, retrospectively, 51 limbs in 46 patients treated for Rutherford 5 CLI with infrainguinal lesions between 2010 and 2012. Endovascular therapy (EVT) and open surgical revascularization (OSR) were performed initially in 28 and 23 limbs, respectively. The interventions were assigned according to the systemic condition and femoropopiliteal TransAtlantic Inter-Society Consensus (TASC) II classification. We investigated early wound healing rates (defined as healing within 90 days) and amputation-free survival (AFS) rates in the EVT and OSR groups. Results: The OSR group had more TASC D lesions (P < 0.0001). The early wound healing rate was significantly higher in the OSR group (OSR 46.1 % vs. EVT 14.3, P = 0.0205); however, the AFS rates did not differ significantly between the groups (P = 0.4031). Preoperative walking ability significantly influenced AFS (P < 0.0001). Conclusions: Our selective endovascular-first approach did not worsen AFS; however, OSR yielded better early wound healing rates. Preoperative walking ability strongly influenced AFS; hence, patients with good walking ability were good candidates for primary OSR. The indications for EVT for earlier wound healing still require better clarification.

AB - Purpose: To evaluate the validity of a selective endovascular-first approach for Rutherford 5 critical limb ischemia (CLI). Methods: We analyzed, retrospectively, 51 limbs in 46 patients treated for Rutherford 5 CLI with infrainguinal lesions between 2010 and 2012. Endovascular therapy (EVT) and open surgical revascularization (OSR) were performed initially in 28 and 23 limbs, respectively. The interventions were assigned according to the systemic condition and femoropopiliteal TransAtlantic Inter-Society Consensus (TASC) II classification. We investigated early wound healing rates (defined as healing within 90 days) and amputation-free survival (AFS) rates in the EVT and OSR groups. Results: The OSR group had more TASC D lesions (P < 0.0001). The early wound healing rate was significantly higher in the OSR group (OSR 46.1 % vs. EVT 14.3, P = 0.0205); however, the AFS rates did not differ significantly between the groups (P = 0.4031). Preoperative walking ability significantly influenced AFS (P < 0.0001). Conclusions: Our selective endovascular-first approach did not worsen AFS; however, OSR yielded better early wound healing rates. Preoperative walking ability strongly influenced AFS; hence, patients with good walking ability were good candidates for primary OSR. The indications for EVT for earlier wound healing still require better clarification.

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