Statin Use Improves Limb Salvage after Intervention for Peripheral Arterial Disease

2020 ◽  
pp. 187-191
Author(s):  
Juan Carlos Jimenez ◽  
Samuel Eric Wilson
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Arterial Disease ◽  
Peripheral Arterial ◽  
Statin Use

scholarly journals Statin use improves limb salvage after intervention for peripheral arterial disease

2019 ◽  
Vol 70 (2) ◽  
pp. 539-546 ◽  
Author(s):  
Gaurav M. Parmar ◽  
Zdenek Novak ◽  
Emily Spangler ◽  
Mark Patterson ◽  
Marc A. Passman ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Arterial Disease ◽  
Peripheral Arterial ◽  
Statin Use

Abstract 117: Statin Use Improves Limb Salvage After Intervention for Peripheral Arterial Disease

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Gaurav Parmar ◽  
Zdenek Novak ◽  
Benjamin J Pearce ◽  
Mark A Patterson ◽  
Emily Spangler ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Cox Regression ◽  
Oral Anticoagulants ◽  
Univariate Analysis ◽  
Arterial Disease ◽  
Lower Mortality ◽  
Social Security Death Index ◽  
Peripheral Arterial ◽  
Statin Use

Background: Statin use is recommended in patients with peripheral arterial disease (PAD) due to its morbidity and mortality benefits. However, the effect of statins on limb salvage in PAD is unclear. We examined the effect of statins on survival and limb salvage among PAD patients undergoing surgical or endovascular intervention. Methods: PAD patients were identified who underwent intervention between 2009 and 2010. Information was collected from electronic medical records and the Social Security Death Index. Univariate analysis was used to determine predictors of ongoing statin use. Survival and freedom from amputation were determined using KM plots and adjusted hazard ratios by Cox regression. Results: A total of 488 PAD patients underwent surgical (n=297) or endovascular (n=191) intervention. 39% were African-American, 44% were female, 41% received statins, 56% received antiplatelet medications, 26% received oral anticoagulants, 9% required a major amputation, and 11% died during follow-up of up to 88 months. Statin users were more often male (p=0.03), caucasian (p=0.03), smokers (p<0.01), and had higher comorbidities such as CAD (p<0.01), hypertension (p<0.01), and diabetes (p<0.01). Antiplatelet use was not associated with amputations (p=0.13), but did lower mortality (p<0.01). Dual antiplatelet therapy did not show any benefit over monotherapy for mortality (p=0.3) or amputations (p=0.4). Statin use was associated with lower mortality (p=0.04), and improved limb salvage (hazard ratio, 0.3; 95% confidence interval, 0.2-0.6) after adjusting for severity of disease as well as antiplatelet and anticoagulation use. Conclusion: Statin use in PAD patients with interventions was associated with improved limb-salvage and survival. Despite existing guidelines, statin therapy was disappointingly low in our PAD population, and efforts will be made to increase use across our health system.

Surgical and endovascular hybrid approach in peripheral arterial disease of the lower limbs

VASA ◽  
2016 ◽  
Vol 45 (5) ◽  
pp. 417-422 ◽  
Author(s):  
Anouk Grandjean ◽  
Katia Iglesias ◽  
Céline Dubuis ◽  
Sébastien Déglise ◽  
Jean-Marc Corpataux ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Hybrid Approach ◽  
Arterial Disease ◽  
Early Mortality ◽  
Secondary Patency ◽  
Limb Salvage Rate ◽  
Peripheral Arterial ◽  
Salvage Rate

Abstract. Background: Multilevel peripheral arterial disease is frequently observed in patients with intermittent claudication or critical limb ischemia. This report evaluates the efficacy of one-stage hybrid revascularization in patients with multilevel arterial peripheral disease. Patients and methods: A retrospective analysis of a prospective database included all consecutive patients treated by a hybrid approach for a multilevel arterial peripheral disease. The primary outcome was the patency rate at 6 months and 1 year. Secondary outcomes were early and midterm complication rate, limb salvage and mortality rate. Statistical analysis, including a Kaplan-Meier estimate and univariate and multivariate Cox regression analyses were carried out with the primary, primary assisted and secondary patency, comparing the impact of various risk factors in pre- and post-operative treatments. Results: 64 patients were included in the study, with a mean follow-up time of 428 days (range: 4 − 1140). The technical success rate was 100 %. The primary, primary assisted and secondary patency rates at 1 year were 39 %, 66 % and 81 %, respectively. The limb-salvage rate was 94 %. The early mortality rate was 3.1 %. Early and midterm complication rates were 15.4 % and 6.4 %, respectively. The early mortality rate was 3.1 %. Conclusions: The hybrid approach is a major alternative in the treatment of peripheral arterial disease in multilevel disease and comorbid patients, with low complication and mortality rates and a high limb-salvage rate.

Limb Salvage in Patients With Peripheral Arterial Disease Managed by Endovascular First Approach

2013 ◽  
Vol 48 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Kyin Kyin May ◽  
Peter Ashley Robless ◽  
Harvinder Raj Singh Sidhu ◽  
Ben Soo Yeng Chua ◽  
Pei Ho
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Arterial Disease ◽  
Peripheral Arterial

scholarly journals Predictors of post-operative outcomes in patients with peripheral arterial disease and critical limb ischaemia: a systematic review and meta-analysis

2021 ◽  
Vol 55 (1) ◽  
pp. 69-76
Author(s):  
Lily P. Wu ◽  
Nadraj G. Naidoo ◽  
Olatunji O. Adetokunboh
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Graft Patency ◽  
Arterial Disease ◽  
Critical Limb Ischaemia ◽  
Wound Complications ◽  
Limb Ischaemia ◽  
Operative Outcomes ◽  
One Year ◽  
Peripheral Arterial

Background: A very small proportion (1%) of patients with peripheral artery disease (PAD) present with critical limb threatening ischaemia (CLTI) with poor prognosis. The present review showcased several pre-operative predictors and key post-operative outcomes. Identification of any modifiable predictors may impact positively on surgical outcomes.Design: PubMed/Medline, Google scholar and Cochrane databases were searched using terms such as “peripheral arterial disease” AND “critical limb ischemia,” “post-operative outcome,” AND “predictors of post-operative outcomes”. Search was for relevant English-language articles published between January 1997 and December 2007 Selected articles were screened first by title and abstract, and selection of full articles was based on relevance using our inclusion and exclusion criteria and quality ratings performed with the MINORS score.Results: The included studies were published between 1997 and 2007. Only six (6) articles out of a total of 2,114 were deemed suitable for analysis. Ambulatory recovery was >70% at six months, 86.7% and 70.0% at one year and five years respectively. Rate of local wound complications was between 12% and 24%. Reported limb salvage rates were >90% at six months, >70% at one year and 70.0-90.0% at five years. Primary graft patency rate at one year ranged from 63% and 76.6%. Gangrene, diabetes and impaired pre-operative ambulatory function are associated with more wound complications, low limb salvage, reduced graft patency and poor functional outcome.Conclusion: Pre-operative ambulatory status was the most important predictor of post-operative ambulatory recovery. Diabetes mellitus was an important risk factor for prolonged wound healing, local wound complications and major amputation.

Limb Salvage With H.E.L.P (Heparin-induced Extracorporeal LDL Precipitation) In Peripheral Arterial Disease (PAD)

1994 ◽  
Vol 28 (6) ◽  
pp. 383-391
Author(s):  
P. Lechner ◽  
M. Walzl ◽  
B. Walzl ◽  
H. Lechner ◽  
H. Cesnik
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Arterial Disease ◽  
Peripheral Arterial
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