Percutaneous transluminal angioplasty associated with a comparable risk of mortality in old patients with severe lower extremities arterial disease

Abstract Background Percutaneous transluminal angioplasty (PTA) improves limb salvage rates in patients with severe lower extremity arterial disease (LEAD). It remains unknown whether PTA can be safely performed to the older LEAD patients. Purpose We investigated the effect of age ≥85 vs <85 years on prognoses in LEAD patients. Methods We analyzed 222 LEAD patients from our previous retrospective cohort study between 2013 and 2018. All patients received percutaneous transluminal angioplasty. Study outcomes were in-hospital mortality and 1-year all-cause mortality and major adverse limb events (MALEs). Results The study included 222 patients aged 74±11 years (54% male), and 12.6% had acute limb ischemia. The older group had significantly higher rates of in-hospital (17.8 vs. 5.1%, P=0.009) and all-cause mortality (37.8% vs. 19.2%, P=0.016), but MALEs were not different significantly (8.9% vs. 16.9%, P=0.247). In multivariate logistic regression analyses, age ≥85 years was not associated with the increased risks of the study outcomes after we adjusted for potential confounders. The risk factors associated with 1-year all-cause mortality was the presence of acute limb ischemia (adjusted HR: 2.978, 95% CI: 1.502–5.905, P=0.002) and Rutherfold stages (adjusted HR: 2.135, 95% CI: 1.248–3.652, P=0.005). Conclusion Compared with the patients aged less than 85 years, the LEAD patients aged more than 85 years had favorable risks of mortality after receiving PTA, and the incident MALEs were not significantly different. FUNDunding Acknowledgement Type of funding sources: None. Study outcomes in LEAD patients

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TCT-803 Twelve-month Clinical Outcomes of Peripheral Arterial Disease Patients with or without Critical Limb Ischemia undergoing Percutaneous Transluminal Angioplasty

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2015.08.1113 ◽

2015 ◽

Vol 66 (15) ◽

pp. B327

Author(s):

Seung-Woon Rha ◽

Byoung Geol Choi ◽

Se Yeon Choi ◽

Jae Kyeong Byun ◽

Jin oh Na ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Clinical Outcomes ◽

Critical Limb Ischemia ◽

Percutaneous Transluminal Angioplasty ◽

Limb Ischemia ◽

Arterial Disease ◽

Transluminal Angioplasty ◽

Peripheral Arterial ◽

Percutaneous Transluminal

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Initial diastolic dysfunction is a powerful predictor of 5-year mortality in peripheral arterial disease patients undergoing percutaneous transluminal angioplasty

Heart and Vessels ◽

10.1007/s00380-021-01823-0 ◽

2021 ◽

Author(s):

Kyung-Hee Kim ◽

Saarwaani Vallabhajosyula ◽

Seung-Woon Rha ◽

Byoung Geol Choi ◽

Jae-Kyung Byun ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Diastolic Dysfunction ◽

Percutaneous Transluminal Angioplasty ◽

Arterial Disease ◽

Transluminal Angioplasty ◽

Powerful Predictor ◽

Peripheral Arterial ◽

Percutaneous Transluminal

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Percutaneous transluminal angioplasty with carbon dioxide for peripheral arterial disease after kidney transplantation: a case report with literature review

Renal Replacement Therapy ◽

10.1186/s41100-020-00275-y ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Masataka Banshodani ◽

Seiji Marubayashi ◽

Sadanori Shintaku ◽

Tomoyasu Sato ◽

Misaki Moriishi ◽

...

Keyword(s):

Carbon Dioxide ◽

Kidney Transplantation ◽

Case Report ◽

Literature Review ◽

Peripheral Arterial Disease ◽

Percutaneous Transluminal Angioplasty ◽

Arterial Disease ◽

Transluminal Angioplasty ◽

Peripheral Arterial ◽

Percutaneous Transluminal

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Overview of the Virtual 2021 FDA’s Circulatory System Devices Advisory Panel on Lutonix 014 Drug-Coated Percutaneous Transluminal Angioplasty Catheter for Below-the-Knee Lesions in Critical Limb Ischemia

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2021.06.016 ◽

2021 ◽

Author(s):

Brian C. Case ◽

Rebecca Torguson ◽

Cheng Zhang ◽

Ron Waksman

Keyword(s):

Critical Limb Ischemia ◽

Percutaneous Transluminal Angioplasty ◽

Circulatory System ◽

Limb Ischemia ◽

Transluminal Angioplasty ◽

Advisory Panel ◽

Below The Knee ◽

Percutaneous Transluminal

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Percutaneous Transluminal Angioplasty and Drug-Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia (PADI) Trial

Circulation Cardiovascular Interventions ◽

10.1161/circinterventions.114.002376 ◽

2016 ◽

Vol 9 (2) ◽

Cited By ~ 31

Author(s):

Marlon I. Spreen ◽

Jasper M. Martens ◽

Bettina E. Hansen ◽

Bob Knippenberg ◽

Elke Verhey ◽

...

Keyword(s):

Critical Limb Ischemia ◽

Percutaneous Transluminal Angioplasty ◽

Limb Ischemia ◽

Transluminal Angioplasty ◽

Drug Eluting Stents ◽

Drug Eluting ◽

Percutaneous Transluminal

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Radiation Exposure during Percutaneous Transluminal Angioplasty for Symptomatic Peripheral Arterial Disease

Annals of Vascular Surgery ◽

10.1016/j.avsg.2015.11.019 ◽

2016 ◽

Vol 33 ◽

pp. 167-172 ◽

Cited By ~ 7

Author(s):

Tim A. Sigterman ◽

Lars J.J. Bolt ◽

Maarten G. Snoeijs ◽

Attila G. Krasznai ◽

Roel Heijboer ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Radiation Exposure ◽

Percutaneous Transluminal Angioplasty ◽

Arterial Disease ◽

Transluminal Angioplasty ◽

Peripheral Arterial ◽

Percutaneous Transluminal

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Evaluation of foot hypoperfusion and estimation of percutaneous transluminal angioplasty outcome in patients with critical limb ischemia using intravoxel incoherent motion microperfusion MRI

British Journal of Radiology ◽

10.1259/bjr.20210215 ◽

2021 ◽

pp. 20210215

Author(s):

Nikolaos Galanakis ◽

Thomas G Maris ◽

Georgios Kalaitzakis ◽

Nikolaos Kontopodis ◽

Nikolas Matthaiou ◽

...

Keyword(s):

Critical Limb Ischemia ◽

Percutaneous Transluminal Angioplasty ◽

Ankle Brachial Index ◽

Limb Ischemia ◽

Transluminal Angioplasty ◽

Lower Limbs ◽

Intravoxel Incoherent Motion ◽

Healthy Individuals ◽

Imaging Protocol ◽

Percutaneous Transluminal

Objectives: To emerge hypoperfusion of lower limbs in patients with critical limb ischemia (CLI) using Intravoxel Incoherent Motion microperfusion magnetic resonance imaging (IVIM-MRI). Moreover to examine the ability of IVIM-MRI to differentiate patients with severe peripheral arterial disease (PAD) from normal subjects and evaluate the percutaneous transluminal angioplasty (PTA) results in patients with CLI. Methods: Eight patients who presented with CLI and six healthy volunteers were examined. The patients underwent IVIM-MRI of lower extremity before and following PTA. The imaging protocol included sagittal diffusion-weighted (DW) sequences. DW images were analyzed and color parametric maps of the micro-circulation of blood inside the capillary network (D*) were constructed. The studies were evaluated by two observers to define interobserver reproducibility. Results: Technical success was achieved in all patients (8/8). The mean ankle-brachial index increased from 0.35 ± 0.2 to 0.76 ± 0.25 (p < 0.05). Successful revascularization improved IVIM microperfusion. Mean D* increased from 279.88 ± 13.47 10−5 mm2/s to 331.51 ± 31 10−5 mm2/s, following PTA, p < 0.05. Moreover, PAD patients presented lower D* values as compared to healthy individuals (279.88 ± 13.47 10−5 mm2/s vs 332.47 ± 22.95 10−5 mm2/s, p < 0.05, respectively). Good interobserver agreement was obtained with an ICC = 0.84 (95% CI 0.64–0.93). Conclusions: IVIM-MRI can detect differences in microperfusion between patients with PAD and healthy individuals. Moreover, significant restitution of IVIM microperfusion is found following successful PTA. Advances in knowledge: IVIM-MRI is a safe, reproducible and effective modality for evaluation of lower limb hypoperfusion in patients with PAD. It seems also to be a helpful tool to detect changes of tissue perfusion in patients with CLI following revascularization.

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