Long-term primary patency prognostic factors after endovascular therapy for acute lower limb ischemia / 中华放射学杂志

ABSTRACT

Objective To assesse prognostic factors regarding long-term primary patency for patients who underwent intra-arterial thrombolysis and/or adjuvant endovascular techniques due to acute lower limb ischemia. Methods Consecutive patients with ALI of the lower extremities treated via interventional methods between January 2005 and June 2010 were identified and reviewed ( exclude patient suffered from aortic dissection involved artery of lower extremity or trauma). Analyze the potential variables with univariable analysis and only factors associated with long-term primary patency with a P value less than 0.1 in univariable analysis were introduced into the Cox regression mode.Total long-term primary patency and grouped primary patency were assessed using Kaplan-Meier estimation.Results The analyzed dataset included 107 limbs treated in 101 patients presenting with ALI (class Ⅰ 15,class Ⅱ A 36,class Ⅱ B to Ⅲ 56,according to Rutherford classification ).Eight nine limbs were enrolled in follow-up.The mean followup was 34 months ( range1 to 53 months).Primary patency at 12,24 and 36 months was 87％,68％ and 55％,respectively.Multivariable analyses identified patients presenting with diabetes mellitus ( P =0.00),PAOD ( P ＜ 0.02 ) and thrombolysis time ( P ＜ 0.02 ) were associated with primary patency.Compare the patency rate of patients with different thrombolysis time,the results showed that the patency rate of the patients thrombolysis time less than 4 d was higher than those more than 4 c. Conclusions lnterventional therapy remains an effective treatment option for patients presenting with lower extremity ALI.Diabetes mellitus and PAOD negatively affect the rates of limb primary patency. Thrombolysis should be limited to ＜4 days.