Perioperative Complications After Aorto-iliac Stenting: Associated Factors and Impact on Follow-up Cardiovascular Prognosis

被引：13

作者：

Iida, O. ^{[1
]}

Soga, Y. ^{[2
]}

Takahara, M. ^{[3
]}

Kawasaki, D. ^{[4
]}

Yamauchi, Y. ^{[5
]}

Suzuki, K. ^{[6
]}

Hirano, K. ^{[7
]}

Koshida, R. ^{[8
]}

Kamoi, D. ^{[9
]}

Tazaki, J. ^{[10
]}

Higashitani, M. ^{[11
]}

Shintani, Y. ^{[12
]}

Yamaoka, T. ^{[13
]}

Okazaki, S. ^{[14
]}

Suematsu, N. ^{[15
]}

Tsuchiya, T. ^{[16
]}

Miyashita, Y. ^{[17
]}

Shinozaki, N. ^{[18
]}

Takahashi, H. ^{[19
]}

Uematsu, M. ^{[1
]}

机构：

[1] Kansai Rosai Hosp, Ctr Cardiovasc, Amagasaki, Hyogo 6608511, Japan

[2] Kokura Mem Hosp, Dept Cardiol, Kitakyushu, Fukuoka, Japan

[3] Osaka Univ, Grad Sch Med, Dept Metab Med, Osaka, Japan

[4] Hyogo Coll Med, Dept Internal Med, Div Cardiovasc, Nishinomiya, Hyogo 6638501, Japan

[5] Kikuna Mem Hosp, Dept Cardiol, Yokohama, Kanagawa, Japan

[6] Sendai Kosei Hosp, Dept Cardiol, Sendai, Miyagi, Japan

[7] Saiseikai Yokohama City Eastern Hosp, Dept Cardiol, Yokohama, Kanagawa, Japan

[8] Tokeidai Mem Hosp, Dept Cardiol, Sapporo, Hokkaido, Japan

[9] Nagoya Kyoritsu Hosp, Dept Cardiol, Nagoya, Aichi, Japan

[10] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan

[11] Tokyo Womens Med Univ, Dept Cardiol, Tokyo, Japan

[12] Shin Koga Hosp, Dept Cardiol, Kurume, Fukuoka, Japan

[13] Matsuyama Red Cross Hosp, Dept Vasc Surg 1, Matsuyama, Ehime, Japan

[14] Juntendo Univ, Nerima Hosp, Dept Cardiol, Tokyo, Japan

[15] Fukuoka Red Cross Hosp, Dept Cardiol, Fukuoka, Japan

[16] Kanazawa Med Univ Hosp, Div Cardiovasc Trans Catheter Therapeut, Kanazawa, Ishikawa, Japan

[17] Shinshu Univ, Dept Adv PAD Therapeut, Matsumoto, Nagano 390, Japan

[18] Tokai Univ Hosp, Dept Cardiol, Isehara, Kanagawa, Japan

[19] Yamagata Univ, Sch Med, Dept Cardiol Pulmonol & Nephrol, Yamagata 99023, Japan

来源：

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY | 2014年 / 47卷 / 02期

关键词：

Aorto-iliac occlusive disease; Endovascular therapy; Perioperative complications; Stent; ENDOVASCULAR TREATMENT; OCCLUSIVE DISEASE; CLINICAL-TRIAL; OUTCOMES; MANAGEMENT; BYPASS;

D O I：

10.1016/j.ejvs.2013.09.024

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objectives: To investigate factors associated with 30-day perioperative complications (POC) after aortoiliac (Al) stenting, and to compare follow-up cardiovascular prognosis between patients with and without POC. Materials and methods: This was a retrospective multicenter study. We used a multicenter database of 2012 consecutive patients who successfully underwent Al stenting for peripheral arterial disease in 18 centers in Japan from January 2005 to December 2009 to analyze independent predictors of POC and impact of POC on prognosis by logistic regression and a Cox proportional hazard regression model, respectively. Results: Mean age was 71 +/- 9 years (median: 72 years; range: 37-98 years), and 1,636 patients (81%) were men. POC occurred in 126 patients (6.3%). In multivariate logistic regression analysis, old age (>= 80 years), critical limb ischemia (CLI), and Trans Atlantic Inter-Societal Consensus (TASC) II class C/D were independently associated with POC with adjusted odds ratios and 95% confidence intervals (CI) of 1.9 (1.3-2.9), 2.3 (1.5-3.4), and 2.4 (1.6-3.4), respectively. Out of 2012 patients, 1995 were followed up for more than 30 days (mean: 2.6 +/- 1.5 years; range: 2-2,393 days). In a Cox hazard regression model adjusted for baseline clinical characteristics, POC was positively and independently associated with follow-up major adverse cardiac events (adjusted hazard ratio [HR]: 1.9; 95% Cl: 1.3-2.8; p = .002), but not with major adverse limb events and target lesion revascularization (adjusted HR: 1.4; 95% CI: 0.7-2.7; p = .25; and adjusted HR: 1.2; 95% CI 0.6-2.6; p = .568), respectively. Conclusions: Age >80 years, CLI, and TASC C/D lesion were positively associated with POC after Al stenting. Occurrence of POC appears to adversely affect follow-up cardiovascular, but not limb and vessel prognosis. (C) 2013 European Society. for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

引用

页码：131 / 138

页数：8

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