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Published online: 2019-10-21
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Body mass index and long-term outcomes in patients with chronic total occlusions undergoing retrograde endovascular revascularization of the infra-inguinal lower limb arteries

Rafał Januszek, Zoltan Ruzsa, Andras Nyerges, Victor Óriás, Paweł Kleczyński, Joanna Wojtasik-Bakalarz, Artur Pawlik, Saleh Arif, Dariusz Dudek, Stanisław Bartuś
DOI: 10.5603/CJ.a2019.0097
·
Pubmed: 31642053

open access

Ahead of print
Original articles
Published online: 2019-10-21

Abstract

Background: The aim of the present study is to assess the relationship between body mass index (BMI) and long-term clinical outcomes in retrograde endovascular recanalization (ER) regarding chronic total occlusions (CTOs) of the infra-inguinal lower limb arteries. Methods: The study included patients who underwent retrograde ER of CTOs localized in  superficial, popliteal or below-the-knee arteries. During follow-up, major adverse cardiac and cerebrovascular (MACCE) and major adverse lower limb events were evaluated (MALE). MALE was defined as amputation, target lesion re-intervention, target vessel re-intervention and surgical treatment. Results: The study included 405 patients at the mean age of 67.2 ± 10.4. The authors divided the overall group of patients according to BMI into < 25 (n = 156, 38.5%) and ≥ 25 kg/m2 (n = 249, 61.5%), and then into < 30 (n = 302, 75.8%) and ≥ 30 kg/m2 (n = 103, 24.2%). During the average follow-up 1,144.9 ± 664.3 days, the mortality rate was higher in the group of patients with BMI < 25 kg/m2 (10.5% vs. 5.3%, p = 0.051), and in the group of patients with BMI < 30 kg/m2 (8.7% vs. 2.9%, p = 0.048). The comparison of Kaplan-Meier curves revealed borderline differences when assessing months to death for the BMI < 25 kg/m2 (p = 0.057) and BMI < 30 kg/m2 (p = 0.056) grouping variables. Conclusions: Obese and overweight patients undergoing CTO ER of the lower limb arteries from retrograde access are related to lower death rates during long-term follow-up.

Abstract

Background: The aim of the present study is to assess the relationship between body mass index (BMI) and long-term clinical outcomes in retrograde endovascular recanalization (ER) regarding chronic total occlusions (CTOs) of the infra-inguinal lower limb arteries. Methods: The study included patients who underwent retrograde ER of CTOs localized in  superficial, popliteal or below-the-knee arteries. During follow-up, major adverse cardiac and cerebrovascular (MACCE) and major adverse lower limb events were evaluated (MALE). MALE was defined as amputation, target lesion re-intervention, target vessel re-intervention and surgical treatment. Results: The study included 405 patients at the mean age of 67.2 ± 10.4. The authors divided the overall group of patients according to BMI into < 25 (n = 156, 38.5%) and ≥ 25 kg/m2 (n = 249, 61.5%), and then into < 30 (n = 302, 75.8%) and ≥ 30 kg/m2 (n = 103, 24.2%). During the average follow-up 1,144.9 ± 664.3 days, the mortality rate was higher in the group of patients with BMI < 25 kg/m2 (10.5% vs. 5.3%, p = 0.051), and in the group of patients with BMI < 30 kg/m2 (8.7% vs. 2.9%, p = 0.048). The comparison of Kaplan-Meier curves revealed borderline differences when assessing months to death for the BMI < 25 kg/m2 (p = 0.057) and BMI < 30 kg/m2 (p = 0.056) grouping variables. Conclusions: Obese and overweight patients undergoing CTO ER of the lower limb arteries from retrograde access are related to lower death rates during long-term follow-up.

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Keywords

lower limb atherosclerosis, chronic total occlusions, retrograde access, clinical outcomes, body mass index

About this article
Title

Body mass index and long-term outcomes in patients with chronic total occlusions undergoing retrograde endovascular revascularization of the infra-inguinal lower limb arteries

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2019-10-21

DOI

10.5603/CJ.a2019.0097

Pubmed

31642053

Keywords

lower limb atherosclerosis
chronic total occlusions
retrograde access
clinical outcomes
body mass index

Authors

Rafał Januszek
Zoltan Ruzsa
Andras Nyerges
Victor Óriás
Paweł Kleczyński
Joanna Wojtasik-Bakalarz
Artur Pawlik
Saleh Arif
Dariusz Dudek
Stanisław Bartuś

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