Angioplastia infrapoplítea: quanto mais artérias tratar, melhor?

Yoshida, Ricardo de Alvarenga; Silva, Carlos Eduardo Cunha da; Sobreira, Marcone Lima; Yoshida, Winston Bonetti

doi:10.1590/s1677-54492008000200016

Cited by 4 publications

(4 citation statements)

References 22 publications

(51 reference statements)

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“…Multiple lesions in distal arteries can limit the success of vascular reconstruction because of deficient runoff. 37 Certain limitations of the present study should be acknowledged. It is a retrospective study and, as such, patient records tend to have a considerable proportion of missing data, which leads to a large number of exclusions and a high probability of biases, thereby weakening the quality of the sample and the study conclusions.…”

Section: Discussionmentioning

confidence: 82%

Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease

et al. 2023

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Background Diabetics are at 5-15 times greater risk of developing peripheral arterial disease (PAD) and few studies have compared risk factors and distribution and severity of arterial changes in diabetics compared with non-diabetics. Objectives To compare angiographic changes between diabetic and non-diabetic patients with advanced PAD and correlate them with risk factors. Methods A retrospective cross-sectional study was conducted of consecutive patients undergoing lower limb arteriography for PAD (Rutherford 3-6) using TASC II and Bollinger et al. angiographic scores. Exclusion criteria were upper limb angiographies, unclear images, incomplete laboratory test results, and previous arterial surgeries. Statistical analyses included chi-square tests, Fisher's test for discrete data, and Student’s t test for continuous data (significance level: p < 0.05). Results We studied 153 patients with a mean age of 67 years, 50.9% female and 58.2% diabetics. A total of 91 patients (59%) had trophic lesions (Rutherford 5 or 6) and 62 (41%) had resting pain or limiting claudication (Rutherford 3 and 4). Among diabetics, 81.7% were hypertensive, 29.4% had never smoked, and 14% had a history of acute myocardial infarction. According to the Bollinger et al. score, infra-popliteal arteries were more affected in diabetics, especially the anterior tibial artery (p = 0.005), while the superficial femoral artery was more affected in non-diabetics (p = 0.008). According to TASC II, the most severe angiographic changes in the femoral-popliteal segment occurred in non-diabetic patients (p = 0.019). Conclusions The most frequently affected sectors were the infra-popliteal sectors in diabetics and the femoral sector in non-diabetics.

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Section: Discussionmentioning

confidence: 82%

Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease

et al. 2023

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“…Multiple lesions in distal arteries can limit the success of vascular reconstruction because of deficient runoff. 37 …”

Section: Discussionmentioning

confidence: 99%

“…Assim, no presente estudo, foi significativa a presença de estenoses nas três principais artérias da perna, porém com associação significativa de estenoses > 50% somente na artéria tibial anterior. As alterações múltiplas em artérias distais podem limitar o sucesso de reconstruções vasculares por deficiência de deságue 37 .…”

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Comparação das alterações angiográficas entre pacientes diabéticos e não diabéticos com doença arterial periférica

et al. 2023

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Resumo Contexto Os diabéticos possuem risco de 5 a 15 vezes maior para o desenvolvimento de doença arterial periférica (DAP), e poucos estudos compararam fatores de risco e a distribuição e gravidade de alterações arteriais angiográficas entre diabéticos e não diabéticos. Objetivos Comparar alterações angiográficas entre pacientes diabéticos e não diabéticos com DAP avançada, correlacionando-as com demais fatores de risco. Métodos Trata-se de um estudo transversal retrospectivo de pacientes consecutivos submetidos a arteriografia de membros inferiores por DAP (Rutherford de 3 a 6), usando os escores angiográficos TASC II e de Bollinger et al. Os critérios de exclusão incluíram arteriografias de membros superiores, exames incompletos ou sem nitidez e cirurgias prévias. A análise estatística incluiu o teste do qui-quadrado ou exato de Fisher para variáveis discretas e o teste t para variáveis contínuas (significância: p < 0,05). Resultados Foram estudados 153 pacientes com idade média de 67 anos, sendo 50,9% do sexo feminino e 58,2% diabéticos. Um total de 91 pacientes (59%) tinha lesão trófica (Rutherford 5 ou 6), enquanto 62 (41%) tinham dor em repouso ou claudicação limitante (Rutherford 3 e 4). Entre os diabéticos, 81,7% eram hipertensos, 29,4% nunca fumaram e 14% tinham antecedente de infarto do miocárdio. Pelo escore de Bollinger et al., as artérias infrapoplíteas foram as mais comprometidas, em especial a tibial anterior (p = 0,005) nos diabéticos, enquanto a femoral superficial foi mais acometida nos não diabéticos (p = 0,008). Pelo TASC II, as alterações arteriográficas mais graves ocorreram no segmento fêmoro-poplíteo nos pacientes não diabéticos (p = 0,019). Conclusões Os setores infrapoplíteos foram os mais comprometidos nos diabéticos, enquanto o setor femoral foi o mais acometido nos não diabéticos.

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“…Today, balloons of up to 15 cm in length are available for 0.035 guide-wires which facilitate the procedures and improve the immediate results from angioplasty of the tibial arteries. 3 Stents have been improved and have been producing even better results, as can be seen in the study by Bosiers et al 4 Their paper provides an extensive review of the literature and results of five types of stents. The bare metal stents are bare metal balloon-expandable stents made with Cobalt Chromium alloy with high radial strength, good fluoroscopic visibility and available in up to 78 mm lengths.…”

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confidence: 99%