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

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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