Clinical Outcomes After Distal Bypass in Patients With Chronic Limb-Threatening Ischemia due to Connective Tissue Disease

被引：0

作者：

Kobayashi, Taira ^{[1
]}

Hamamoto, Masaki ^{[1
]}

Okazaki, Takanobu ^{[1
]}

Okusako, Ryo ^{[1
]}

Shimoda, Hironori ^{[2
]}

Hasegawa, Misa ^{[3
]}

Takahashi, Shinya ^{[4
]}

机构：

[1] JA Hiroshima Gen Hosp, Dept Cardiovasc Surg, 1-3-3 Jigozen, Hatsukaichi, Hiroshima 7388503, Japan

[2] JA Hiroshima Gen Hosp, Dept Nephrol, Hatsukaichi, Japan

[3] JA Hiroshima Gen Hosp, Dept Plast Surg, Hatsukaichi, Japan

[4] Hiroshima Univ Hosp, Dept Cardiovasc Surg, Hiroshima, Japan

来源：

VASCULAR AND ENDOVASCULAR SURGERY | 2025年 / 59卷 / 03期

关键词：

connective tissue disease; chronic limb-threatening ischemia; distal bypass; limb salvage; wound healing; LONG-TERM OUTCOMES; ARTERY-BYPASS; CLASSIFICATION; MANAGEMENT;

D O I：

10.1177/15385744241290012

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objectives: Chronic limb-threatening ischemia (CLTI) is mostly caused by arteriosclerosis, but is sometimes due to connective tissue disease. However, there is a limited knowledge of clinical outcomes of patients with CLTI with connective tissue disease. The objective of the study was to assess outcomes after distal bypass in these patients using global vascular guidelines. Material and Methods: Data from distal bypasses performed for CLTI at a single center from 2014 to 2023 were evaluated retrospectively. Clinical outcomes after distal bypass were compared for patients with CLTI with arteriosclerosis (AS group) and those with connective tissue disease (CD group). The primary endpoints were limb salvage and wound healing. Results: Of the 282 distal bypasses performed for 222 patients with CLTI, 22 were conducted for 21 patients with connective tissue disease (CD group). The connective tissue disease was progressive systemic scleroderma (n = 11 patients), pemphigoid diseases (n = 2), polyarteritis nodosa (n = 2), rheumatoid arthritis (n = 2), and others (n = 4). Compared with the AS group, the CD group included more females (P = .007) and had greater oral steroid use (P < .001) and a higher Global Limb Anatomical Staging System (GLASS) inframalleolar (IM) modifier P2 (P < .001). The mean follow-up period of the whole cohort was 27 +/- 22 months with no significant difference between the groups (P = .25), and 22 limbs required major amputation during this period. The 2-year limb salvage rate was significantly lower in the CD group compared to the AS group (75% vs 94%, P = .020). Wound healing was achieved in 220 (78%) limbs, and the 12-month wound healing rate was significantly lower in the CD group (52% vs 86%, P = .006). Conclusion: The low 2-year limb salvage and 12-month wound healing rates in patients with CLTI with connective tissue disease indicate that distal bypass may be challenging in these patients.

引用

页码：243 / 249

页数：7

共 24 条

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