Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing

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• 作者：Makoto Utsunomiya ; MD ; PhD^a ; ^{m.utsu0705@gmail.com} ; Mitsuyoshi Takahara ; MD^b ; ^c ; Osamu Iida ; MD^d ; Yasutaka Yamauchi ; MD^e ; Daizo Kawasaki ; MD^f ; Yoshiaki Yokoi ; MD ; PhD^g ; Yoshimistu Soga ; MD^h ; Norihiko Ohura ; MDⁱ ; Masato Nakamura ; MD ; PhD^j ; on behalf of the OLIVE Investigators
• 关键词：critical limb ischemia ; endovascular therapy ; wound healing
• 刊名：JACC: Cardiovascular Interventions
• 出版年：2017
• 出版时间：23 January 2017
• 年：2017
• 卷：10
• 期：2
• 页码：188-194
• 全文大小：543 K
• 卷排序：10

文摘

This study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing.BackgroundSeveral reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear.MethodsWe conducted a subanalysis of the prospective multicenter OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia) registry investigation assessing patients who received infrainguinal EVT for CLI. We analyzed data from 185 limbs with ischemic ulcerations classified as Rutherford class 5 or 6, managed with EVT alone (i.e., not undergoing bypass surgery). The wound healing rate after EVT was estimated by the Kaplan-Meier method. The association between final angiographic data and wound healing was assessed employing a Cox proportional hazards model.ResultsThe overall wound healing rate was 73.5%. The probabilities of wound healing in patients with wound blush obtainment was significantly higher than that of those without wound blush (79.6% vs. 46.5%; p = 0.01). In the multivariate analysis, wound blush obtainment was an independent predictor of wound healing.ConclusionThe presence of wound blush after EVT is significantly associated with wound healing. Wound blush as an angiographic endpoint for EVT may serve as a novel predictor of wound healing in patients with CLI.