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Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort


Johner, Fabian; Clemens, Robert; Husmann, Marc; Thalhammer, Christoph; Seifert, Burkhardt; Amann-Vesti, Beatrice (2016). Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort. Vasa, 45(3):247-252.

Abstract

BACKGROUND We evaluated the long-term outcome after endovascular revascularisation for acute limb ischaemia (ALI). PATIENTS AND METHODS From a prospectively maintained database, 318 endovascular interventions for ALI were identified between 2004 and 2010. Event history and survival were analysed using the Kaplan-Meier method and Cox regression. Endpoints were target vessel revascularisation (TVR), non-target extremity revascularisation (NTER), amputation, major vascular events, coronary artery revascularisation and amputation-free survival. RESULTS Follow-up data of 303 patients (mean age 68.5 ± 12.7 years, 40 % female) were available. The mean follow-up time was 38.7 ± 26.2 months. TVR was performed in 40.1 ± 2.9 % at 1 year and 66.5 ± 3.8 % at 5 years. NTER at 1 and 5 years were 7.1 ± 1.5 % and 29.2 ± 4 %, respectively. The proportion of patients who needed major or minor amputation was 4.3 ± 1.2 % after 1 year and 9 ± 2.1 % after 5 years. Amputation-free survival at 1 year was 90.3 ± 1.8 % and 74.8 ± 3.2 % at 5 years. Coronary artery disease (HR 2.22, 95 % CI 1.33 to 3.7, p = 0.002) and atrial fibrillation (HR 2.56, % CI 1.3 to 5.04, p = 0.007) were independently associated with a worse amputation-free survival. The cumulative proportion surviving one year following acute limb ischemia was 95.4 ± 1.2 % and 79.7 ± 3.1 % after 5 years. CONCLUSIONS Long-term amputation-free survival after successful revascularisation for ALI is high; negative predictors are coronary artery disease and atrial fibrillation.

Abstract

BACKGROUND We evaluated the long-term outcome after endovascular revascularisation for acute limb ischaemia (ALI). PATIENTS AND METHODS From a prospectively maintained database, 318 endovascular interventions for ALI were identified between 2004 and 2010. Event history and survival were analysed using the Kaplan-Meier method and Cox regression. Endpoints were target vessel revascularisation (TVR), non-target extremity revascularisation (NTER), amputation, major vascular events, coronary artery revascularisation and amputation-free survival. RESULTS Follow-up data of 303 patients (mean age 68.5 ± 12.7 years, 40 % female) were available. The mean follow-up time was 38.7 ± 26.2 months. TVR was performed in 40.1 ± 2.9 % at 1 year and 66.5 ± 3.8 % at 5 years. NTER at 1 and 5 years were 7.1 ± 1.5 % and 29.2 ± 4 %, respectively. The proportion of patients who needed major or minor amputation was 4.3 ± 1.2 % after 1 year and 9 ± 2.1 % after 5 years. Amputation-free survival at 1 year was 90.3 ± 1.8 % and 74.8 ± 3.2 % at 5 years. Coronary artery disease (HR 2.22, 95 % CI 1.33 to 3.7, p = 0.002) and atrial fibrillation (HR 2.56, % CI 1.3 to 5.04, p = 0.007) were independently associated with a worse amputation-free survival. The cumulative proportion surviving one year following acute limb ischemia was 95.4 ± 1.2 % and 79.7 ± 3.1 % after 5 years. CONCLUSIONS Long-term amputation-free survival after successful revascularisation for ALI is high; negative predictors are coronary artery disease and atrial fibrillation.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:May 2016
Deposited On:24 May 2016 15:34
Last Modified:27 Aug 2016 03:07
Publisher:Hogrefe Verlag
ISSN:0301-1526
Free access at:Related URL. An embargo period may apply.
Publisher DOI:https://doi.org/10.1024/0301-1526/a000532
Related URLs:http://www.zora.uzh.ch/125717/
PubMed ID:27129071

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