Microalbuminuria Is Not A Risk Factor for Restenosis for Patients with Below The Knee Artery Disease and Critical Limb Ischemia Underwent Endovascular Therapy.

Year 2018, , 247 - 253, 29.06.2018

Burak Teymen , Süleymen Aktürk

https://doi.org/10.31832/smj.378971

Abstract

Objective: The aim of this
study was to determine whether microalbuminuria (MA) is
predictive of restenosis in patients with below the knee artery (BTK) disease
and treated with endovascular therapy (EVT).

Method: We retrospectively identified patients from May
2012 to September 2016 at our clinic with
severely diseased BTK arteries successfully treated by endovascular approach and
measured microalbuminuria (MA) recently before intervention. All
patients had ankle-brachial index (ABI) measured before and after the
intervention, and regular clinical follow-up with Doppler ultrasonography
performed at 1 month, 6 months and 1 year. Patients underwent peripheral
angiography if needed.

Results: 46 patients with
BTK arteries critical stenosis or occlusion treated with endovascular therapy
and measurement of MA (through three months before intervention) in our institute
were included. Patients were divided into two groups with MA and MA not seen
(MANS). There were 8 restenosis in the MA
group (63.6% patency rate) and 5 restenosis in the MANS group (77.3 % patency
rate) at 1 year (p=0.517). There were four minor amputations in MA group (17.4
%) and three minor amputations in MANS group (13.0 %, p=1.000). A
statistically significant increase in the ABI (MA before 0.45±0.11 vs. after 0.89±0.08 p<0.01
MANS before 0.43±0.10 vs. after 0.89±0.07 p<0.01) and improvement in Rutherford staging (p<0.01) was
noted in both groups following intervention.

Conclusion: MA is not a predictive factor for
restenosis or amputation rate in patients with BTK arterial disease treated
with endovascular therapy

Keywords

microalbuminuria, drug eluting balloon, peripheral arterial disease, peripheral intervention, restenosis

Mikroalbuminüri, Kritik Uzuv İskemisi Sebebi ile Diz Altı Arterlere Uygulanan Endovasküler Tedavide Restenoz İçin Risk Faktörü Değildir.

Abstract

Amaç: Bu çalışmada mikroalbuminürinin
dizaltı arterlere yapılan endovasküler girişim sonrası restenozda prediktif olup
olmadığı araştırıldı.

Yöntemler: Çalışmamıza
retrospektif olarak Mayıs 2012 ve Eylül 2016 tarihleri arasında dizaltı
arterleride ciddi darlık veya tıkanıklıkları olan ve başarılı olarak
endovasküler yöntem ile tedavi edilmiş ve yakın zaman içinde mikroalbuminüri
değerleri ölçülmüş hastalar dahil edildi. Bütün hastalarda işlem öncesi ve
sonrası ayak bileği/brakiyal indeks (ABI) değerlendirilmek ile birlikte,
düzenli klinik takipte 1, 6, ve 12. Ayda doppler ultrasonları yapıldı.  Ultrason sonuçlarına göre gerekli görülen
hastalarda anjiyografi yapıldı.

Bulgular: Kliniğimizde
dizaltı arterlerinde ciddi darlığı veya tıkanıklığı olan ve mikroalbuminürisi
ölçülmüş (işlemden 3 ay öncesine kadar sürede) endovasküler yaklaşım ile
tedavisi yapılmış 46 hasta çalışmaya dahil edildi. Hastalar mikroalbuminürisi
olup olmamasına göre 2 gruba ayrıldı (MA grup, MANS grup). MA grubunda 8
restenoz (63.6 % primer açık kalım oranı), MANS grubunda 5 restenoz (77.3 %
primer açık kalım oranı) gözlendi. ABI’ de iki grupta da istatistiksel olarak
önemli artış görülmek ile birlikte (MA before 0.45±0.11
vs. after 0.89±0.08 p<0.01 MANS before 0.43±0.10 vs.
after 0.89±0.07 p<0.01
, Rutherford sınıflamasında da istatistiksel olarak önemli iyileşme (p<0.01)
gözlendi.

Sonuç: MA, dizaltı
arterlerinde kritik darlık veya tıkanıklığı olan ve endovasküler yaklaşım ile
tedavi edilmiş hastalarda ampütasyon oranı veya restenozu öngörmemektedir.

Keywords

mikroalbuminüri, ilaç kaplı balon, periferik arter hastalığı, periferik girişim, restenoz

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