Clinical Outcome After Extended Endovascular Recanalization in Buerger's Disease in 20 Consecutive Cases

被引:69
作者
Graziani, Lanfroi [1 ]
Morelli, Luis [2 ]
Parini, Francesca [3 ]
Franceschini, Laura [3 ]
Spano, PierFranco [3 ]
Calza, Stefano [4 ]
Sigala, Sandra [3 ]
机构
[1] Ist Clin Citta Brescia, Invas Cardiol Unit, I-25124 Brescia, Italy
[2] Calderon Guardia Hosp, Vasc & Endovasc Unit, San Jose, Costa Rica
[3] Univ Brescia, Pharmacol Sect, Dept Biomed Sci & Biotechnol, Sch Med, Brescia, Italy
[4] Univ Brescia, Sect Med Stastist & Biometry, Dept Biomed Sci & Biotechnol, Brescia, Italy
关键词
THROMBOANGIITIS-OBLITERANS; PERIPHERAL ANGIOPLASTY; THERAPY; BYPASS; RECONSTRUCTION;
D O I
10.1016/j.avsg.2011.08.014
中图分类号
R61 [外科手术学];
学科分类号
100210 [外科学];
摘要
Background: To present our experience of extended endovascular management for thromboangiitis obliterans (Buerger's disease) patients with critical limb ischemia (CLI). Methods: Between January 2005 and July 2010, a consecutive series of 17 Buerger's disease patients with CLI in 20 limbs were admitted and the diagnosis confirmed. The mean age of the patients was 41.5 years (standard error: +/- 1.7). All patients presented with history of smoking, one patient presented with hypertension, and eight patients presented with dyslipidemia. According to Rutherford classification, all patients were found to be between grades 3 and 5. Ultrasonography first, and angiography examination later, confirmed a severe arterial disease involving almost exclusively below-the-knee and foot arteries in all cases. A new approach for revascularization, defined as extended angioplasty of each tibial and foot artery obstruction, was performed to achieve direct perfusion of at least one foot artery. Results: An extensive endovascular treatment was intended in all patients with success in 19 of 20 limbs, achieving a technical success in 95%. No mortality or complication related to the procedure was observed. During a mean follow-up of 23 months (standard error: +/- 4.05), amputation-free survival with no need of major amputation in any case and sustained clinical improvement was achieved in 16 of the 19 limbs (84.2%) successfully treated, resulting in a 100% limb salvage rate (19/19). Conclusion: In this first experience, in patients with thromboangiitis obliterans, extended endovascular intervention was a feasible and effective revascularization procedure in case of CLI. High technical success, amputation-free survival, and sustained clinical improvement rates were achieved at midterm follow-up was achieved.
引用
收藏
页码:387 / 395
页数:9
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