ORIGINAL ARTICLE  PERIPHERAL ARTERIAL DISEASE Free access

International Angiology 2020 April;39(2):145-54

DOI: 10.23736/S0392-9590.20.04288-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Nutritional status and outcomes of superficial femoral artery stenting due to intermittent claudication

Marta SPYCHALSKA-ZWOLIŃSKA, Marzena ANASZEWICZ, Joanna WIŚNIEWSKA, Marcin WASIELEWSKI, Artur MIECZKOWSKI, Gabriel KOWALCZYK, Banaś WIOLETTA, Beata CZERNIAK, Karol SUPPAN, Jacek BUDZYŃSKI ✉

Department of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland

BACKGROUND: The pathogenesis of in-stent restenosis is still not clear. The aim of this study was to determine the nutritional status of patients with lower limb ischemia and the risk of target lesion revascularization (TLR) after superficial femoral artery (SFA) stenting.
METHODS: Numerous parameters of nutritional status assessment were compared between 70 patients undergoing SFA endovascular intervention with a self-expandable plane stent due to life-limiting intermittent claudication and 40 patients undergoing carotid artery stenting (CAS). All subjects were followed up for at least 1 year in relation to outcomes such as clinically driven TLR occurrence.
RESULTS: Patients undergoing SFA stenting had a lower prevalence of overweight and obesity than those who underwent CAS (51.43% vs. 72.50%; P=0.031). An increase in Ankle-Brachial Index of >0.15 after SFA stenting (early end-point) was positively associated with greater handgrip strength (HGS), fat-free mass, skeletal muscle mass and waist-to-hip ratio. Freedom from TLR (late end-point) was significantly related to a higher waist-to-height ratio (WHtR), HGS and Geriatric Nutritional Risk Index (GNRI) Score. The 1-year risk of TLR for patients with a WHtR of ≥61.39 amounted to odds ratio; 95% confidence interval: 0.21; 0.05-0.25; P=0.021.
CONCLUSIONS: Parameters of nutritional status assessment were associated with early and late outcomes of SFA stenting in patients with intermittent claudication. Abdominal fat distribution and higher HGS and GNRI scores lowered the 1-year risk of TLR. Further study is needed to determine the pathomechanism of the obesity paradox, sarcopenia and undernutrition in relation to outcomes of endovascular interventions.

KEY WORDS: Intermittent claudication; Lower extremity; Ischemia; Obesity; Sarcopenia; Femoral artery