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International Angiology 2017 August;36(4):332-9

DOI: 10.23736/S0392-9590.16.03759-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Results of surgical interventions for critical limb ischemia due to vasculitis or collagen-tissue related disease

Kota YAMAMOTO , Katsuyuki HOSHINA, Atsushi AKAI, Toshihiko ISAJI, Daisuke AKAGI, Takuya MIYAHARA, Toshiaki WATANABE

Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan


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BACKGROUND: In this study, we aimed to clarify both systemic and local prognosis after surgical interventions for critical limb ischemia (CLI) due to vasculitis or connective tissue related disease, and to search for any risk factors that can worsen the prognosis.
METHODS: One hundred and ninety three patients that underwent surgical interventions for CLI between 2005 and 2014 were followed up for a median of 2.7 years. The patients were grouped into a group with vasculitis or connective tissue related disease (V) or with atherosclerosis (control: C). Two groups were retrospectively reviewed and compared.
RESULTS: Thirty-one patients were grouped into the V group. At three years after intervention, V group showed significantly higher survival rate compared to C group (89% vs. 73%). On the other hand, limb survival rate after bypass surgery was significantly lower (74% vs. 94%), due to lower patency of the bypassed graft. Within V group, preoperative skin perfusion pressure of lower than 20 mmHg showed significantly worse prognosis of the limb. (HR 1.8; P=0.01) Regarding specific diseases, systemic scleroderma, rheumatoid arthritis and systemic lupus erythematosus tended to show worse prognosis.
CONCLUSIONS: Patients with CLI due to vasculitis or connective tissue related disease have a longer life expectancy with lower limb salvage rate that can lead to low quality of the remaining life.


KEY WORDS: Ischemia - Lower extremities - Vasculitis

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