Alt Ekstremite İskemisi Nedeniyle Endovasküler Girişim Planlanan Hastaların Klinik Sonuçları ve Koroner Arter Hastalığı Açısından Değerlendirilmesi

Abstract

Amaç: Bu çalışmada, endovasküler girişim planlanan periferik tıkayıcı arter hastalığı teşhisi konulan hastalarda koroner arter hastalığı ve klinik sonuçları incelendi.

Gereç ve Yöntemler: Ocak 2013 ile Ağustos 2017 tarihleri arasında alt ekstremite arterlerinin herhangi birisinde %70 ya da daha fazla stenoz nedeniyle endovasküler girişim planlanan ve aynı zamanda koroner anjiografisi yapılan 114 periferik arter hastalığı olgusu çalışmaya dahil edilmiştir. Hastalar koroner arter stenoz derecesine göre üç gruba ayrıldı. Grup 1: Koroner arter stenozu olmayanlar veya <%40 stenozis olanlar, Grup 2: ≥ 40% ve <70% stenozis olanlar, Grup 3: ≥70% stenozis olanlar. Gruplar yaş, cinsiyet, lipit profilleri (total kolesterol, LDL,HDL, trigliserit), ek hastalıklar (hipertansiyon, diabetes mellitus, kronik obstruktif akciğer hastalığı), alt ekstremite amputasyonu ve mortalite açısından retrospektif olarak karşılaştırılmıştır.

 

Bulgular: Ortalama yaş 66.56±11.65’tir. Olguların 100’ü (%87.7) erkekti. Olguların 8'sinde (%7.0) %40-70 arası darlık olan koroner arter hastalığı, 75'inde (%65.8) %70'in üzerinde darlık olan önemli koroner arter hastalığı saptandı. Olguların 61'i (%53.5) hipertansiyon, 31'i (%27.2) diyabetes mellitus, 78'ü (%68.4) dislipidemi, 10'u (%8.8) kronik obstrüktif akciğer hastalığına sahipti. Mortalite oranı bir yıllık takibi yapılabilen hastalarda %17.5 (20 hasta) bulundu. Grup 1’de yaş ortalaması diğer iki gruptan istatistiksel olarak anlamlı düşük çıktı. Gruplar arasında diğer klinik sonuçlar açısından anlamlı fark bulunmadı.

Sonuç: Periferik tıkayıcı arter hastalığı olan hastalarda koroner arter hastalığı prevalansının yüksek olması nedeniyle bu hastalarda tarama amaçlı rutin koroner arter anjiografi yapılması kardiyovasküler mortalite ve morbiditenin azaltılması açısından önemlidir.

 

Keywords

• Periferik arter hastalığı,koroner arter hastalığı,koroner arter anjiografi

Evaluation of Clinical Outcomes and Coronary Artery Disease in Patients Scheduled for Endovascular Intervention due to Lower Extremity Ischemia

Abstract

Objectives:  In this study, clinical outcomes and coronary artery disease in patients diagnosed with peripheral occlusive artery disease who were scheduled to have an endovascular intervention procedure were investigated.

 

Materials and Methods: 114 peripheral artery disease patients who were planned to undergo an endovascular intervention due to stenosis of 70% or more in any one of lower limb arteries between January 2013 and August 2017 and underwent coronary artery angiography at the same time were included in this study. Patients were divided into three groups according to the degree of the stenosis in their coronary arteries. Group 1: patients without CAD or having <40% of stenosis, Group 2: patients having 40% or more but less than 70% of stenosis, Group 3: patients with ≥70% of stenosis. The groups were retrospectively compared in terms of age, gender, lipid profiles (total cholesterol, LDL, HDL, and triglyceride), other diseases (hypertension, diabetes mellitus, and chronic obstructive pulmonary disease), lower extremity amputation, and mortality.

Results: The mean age was 66.56 ± 11.65. 100 of the cases (87.7%) were male. Eight of the cases (7.0%) had coronary artery disease with a stenosis of 40-70%, and 75 patients (65.8%) had significant coronary artery disease with stenosis of 70% and above. 61 (53.5%) of the cases had hypertension, 31 (27.2%) had diabetes mellitus, 78 (68.4%) cases had dyslipidemia,  and 10 (8.8%) cases had chronic obstructive pulmonary disease. The mortality rate was 17.5% (20 patients) in patients who could be followed up for one year. The mean age of group 1 was statistically significantly lower than the other two groups. No significant difference was found between the groups in terms of other clinical outcomes.

Conclusion: Because of the high incidence of coronary artery disease in patients with peripheral occlusive artery disease, it is important to screen these patients via routine coronary artery angiography to decrease cardiovascular mortality and morbidity.

Keywords

• Peripheral artery disease,coronary artery disease,coronary artery angiography

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