Long-Term Clinical Outcomes after Endovascular Therapy for Anti-Centromere Antibody-Positive Patients with Critical Limb-Threatening Ischemia |
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| Affiliation: | 1. Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan;2. Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan;3. Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Hyogo, Japan;1. Department of Vascular Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China;2. Department of Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China;1. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea;2. Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea;3. Department of Radiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea;1. St Mary''s Hospital, Imperial College Healthcare NHS Trust, London, UK;2. Sahlgrenska University Hospital, Gothenburg, Sweden;1. Neurointerventional and Interventional Vascular Unit, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;2. Service de Réanimation, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;3. Service de Radiologie, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;1. Department of Neurology, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand;2. Department of Interventional Radiology, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand;3. Central Oregon Radiology Associates, Bend, Oregon;4. New Zealand Brain Research Institute, Christchurch, New Zealand |
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| Abstract: | PurposeTo examine the long-term clinical outcomes of patients with anti-centromere antibody (ACA)-positive critical limb-threatening ischemia (CLTI) who were treated with endovascular therapy (EVT).Materials and MethodsThis was a retrospective analysis using a database of 423 consecutive CLTI patients (543 limbs, Rutherford class 4–6) who underwent EVT between January 2011 and March 2013. The patients were divided into 2 groups: an ACA-positive group (10 limbs, 8 patients) and a control group (46 limbs, 43 patients). The control group was defined as female, non-dialysis, and those who were able to obtain a below-knee angiogram.ResultsNone of the 8 ACA-positive CLTI patients had previously been diagnosed as ACA positive. No significant difference was observed in the below-the-knee lesion distribution and severity between the ACA-positive group and the control group. The median observational period was 51 months. The survival rate was 54% in the ACA-positive group and 76% in the control group at 5 years after EVT (P = .732). The freedom from major amputation rate was 60% in the ACA-positive group and 91% in the control group at 5 years after EVT (P = .029). The technical EVT success rate in the ACA-positive group was 70% (7/10). Of the successful EVT cases, 71% (5/7) of patients achieved complete wound healing or rest pain relief; however, 60% (3/5) had a recurrence of wounds.ConclusionsIn a series of ACA-positive patients with CLTI, successful EVT had acceptable outcomes with respect to wound healing with short-term results. However, the major amputation rate for ACA-positive patients was high in long-term follow-up. |
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| Keywords: | ACA"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"anti-centromere antibody CTLI"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"critical limb-threatening ischemia EVT"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"endovascular therapy |
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