题名 | The Use of the Angiosome Concept for Treating Infrapopliteal Critical Limb Ischemia through Interventional Therapy and Determining the Clinical Significance of Collateral Vessels |
作者 | |
发表日期 | 2016-04 |
发表期刊 | ANNALS OF VASCULAR SURGERY 影响因子和分区 |
语种 | 英语 |
原始文献类型 | Article |
其他关键词 | REVASCULARIZATION ; OUTCOMES ; PREDICTORS |
摘要 | Background: The purpose of this study was to evaluate the clinical significance of the involvement of collateral vessels in interventional therapy based on the angiosome concept for infrapopliteal critical limb ischemia (CLI). Methods: We enrolled 486 patients with unilateral infrapopliteal CLI (Rutherford Stage 5 or 6) treated at 2 hospitals from January 2005 to December 2014. Using the angiosome concept, the patients were categorized into 3 groups: the direct revascularization (DR) group, the indirect revascularization through collaterals (IR-tc) group, and the indirect revascularization without collaterals (IR-wc) group. The data from 1 year of follow-up after the initial surgery were analyzed for all 3 groups. Results: During the 1-year follow-up, the unhealed ulcer rate of the IR-wc group was significantly higher than that of the DR group (83.4% vs. 31.7%, P < 0.001) and the IR-tc group (83.4% vs. 34.8%, P < 0.001). Furthermore, the limb salvage rate of the IR-wc group was significantly lower than that of the DR group (70.4% vs. 89.2%, P < 0.001) and the IR-tc group (70.4% vs. 85.4%, P = 0.0013). However, there were no differences in the unhealed ulcer rate or the limb salvage rate between the DR group and the IR-tc group (31.7% vs. 34.8%, P = 0.096 and 89.2% vs. 85.4%, P = 0.2834, respectively). In addition, within the IR-wc group, the unhealed ulcer rate of diabetic patients was higher than that of patients without diabetes (90.0% vs. 74.6%, P = 0.0116), but there was no difference in the limb salvage rate between diabetic and nondiabetic patients. No differences in the unhealed ulcer rate or the limb salvage rate were found between diabetic and nondiabetic patients in the other 2 groups. Conclusions: Following the angiosome model of perfusion for endovascular therapy, directly revascularizing the feeding artery and indirectly achieving revascularization through collaterals can effectively prompt the healing of ulcers and decrease the amputation rate in patients with infrapopliteal CLI. Collateral vessels play a crucial role in the treatment of ischemic foot. |
资助项目 | National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81200233]; Science and Technology Bureau of Wenzhou City [Y20140147] |
出版者 | ELSEVIER SCIENCE INC |
出版地 | NEW YORK |
ISSN | 0890-5096 |
EISSN | 1615-5947 |
卷号 | 32页码:41-49 |
DOI | 10.1016/j.avsg.2015.09.021 |
页数 | 9 |
WOS类目 | Surgery ; Peripheral Vascular Disease |
WOS研究方向 | Surgery ; Cardiovascular System & Cardiology |
WOS记录号 | WOS:000372944000008 |
收录类别 | SCIE ; PUBMED ; SCOPUS |
URL | 查看原文 |
PubMed ID | 26802295 |
SCOPUSEID | 2-s2.0-84961165315 |
通讯作者地址 | [Wu, Zi-Heng]Department of Vascular Surgery,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China |
Scopus学科分类 | Surgery;Cardiology and Cardiovascular Medicine |
引用统计 | |
文献类型 | 期刊论文 |
条目标识符 | https://kms.wmu.edu.cn/handle/3ETUA0LF/17077 |
专题 | 附属第一医院_血管外科 附属第一医院_肿瘤外科 |
通讯作者 | Wu, Zi-Heng |
作者单位 | 1.Department of Vascular Surgery,First Affiliated Hospital,Wenzhou Medical University,Nanbaixiang, Ouhai District, Wenzhou, Zhejiang,325015,China; 2.Department of Oncological Surgery,First Affiliated Hospital,Wenzhou Medical University,Wenzhou,310003,China; 3.Department of Vascular Surgery,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China |
第一作者单位 | 附属第一医院 |
第一作者的第一单位 | 附属第一医院 |
推荐引用方式 GB/T 7714 | Zheng, Xiang-Tao,Zeng, Rui-Chao,Huang, Jing-Yong,et al. The Use of the Angiosome Concept for Treating Infrapopliteal Critical Limb Ischemia through Interventional Therapy and Determining the Clinical Significance of Collateral Vessels[J]. ANNALS OF VASCULAR SURGERY,2016,32:41-49. |
APA | Zheng, Xiang-Tao., Zeng, Rui-Chao., Huang, Jing-Yong., Pan, Le-Men., Su, Xiang., ... & Yu, Guan-Feng. (2016). The Use of the Angiosome Concept for Treating Infrapopliteal Critical Limb Ischemia through Interventional Therapy and Determining the Clinical Significance of Collateral Vessels. ANNALS OF VASCULAR SURGERY, 32, 41-49. |
MLA | Zheng, Xiang-Tao,et al."The Use of the Angiosome Concept for Treating Infrapopliteal Critical Limb Ischemia through Interventional Therapy and Determining the Clinical Significance of Collateral Vessels".ANNALS OF VASCULAR SURGERY 32(2016):41-49. |
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