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Original article
Published online: 2021-05-18
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Endothelial function in patients with critical and non-critical limb ischemia undergoing endovascular treatment

Paweł Kaczmarczyk, Marzena Frołow, Rafał Januszek, Andrzej Belowski, Iwona Gregorczyk-Maga, Stefan Chlopicki, Paweł Maga
DOI: 10.33963/KP.a2021.0010
·
Pubmed: 34002844

open access

Online first
Original article
Published online: 2021-05-18

Abstract

Background: Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease. CLI patients, compared to non-CLI, achieve worse treatment outcomes and generate higher costs.

Aims: The aim of the study was to compare endothelial function and clinical outcomes in CLI and non-CLI patients after percutaneous transluminal angioplasty (PTA).

Methods: In this prospective, follow-up study, 30 CLI patients and 40 non-CLI patients underwent PTA. Endothelial function was assessed based on flow-mediated dilatation (FMD), reactive-hyperaemia index (RHI), while the ankle-brachial index, toe-brachial index and the Rutherford scale were used for PAD progression evaluation. The results were assessed before as well as 1, 3, 6 and 12 months after PTA.

Results: There were no differences at the baseline regarding to endothelial function between both groups. Neither FMD nor RHI changed after PTA in any of the groups, although there was a difference in median RHI value between CLI and non-CLI patients regarding the 1st and 6th month of the follow-up (RHI6–RHI1 = 0.08 in CLI and -0.15 in non-CLI; P = 0.01). The larger baseline intima-media (IMT) in the CLI group allowed to predict a greater number of reintervention (P = 0.01) and major adverse event rates (P = 0.03). CLI patients presented larger decrease in the Rutherford scale compared to non-CLI (P < 0.001).

Conclusions: Baseline IMT was predictive for re-interventions and major adverse event rates. Although neither of groups exhibited significant changes in endothelial function, we proved differences between them regarding to changes in RHI.

Abstract

Background: Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease. CLI patients, compared to non-CLI, achieve worse treatment outcomes and generate higher costs.

Aims: The aim of the study was to compare endothelial function and clinical outcomes in CLI and non-CLI patients after percutaneous transluminal angioplasty (PTA).

Methods: In this prospective, follow-up study, 30 CLI patients and 40 non-CLI patients underwent PTA. Endothelial function was assessed based on flow-mediated dilatation (FMD), reactive-hyperaemia index (RHI), while the ankle-brachial index, toe-brachial index and the Rutherford scale were used for PAD progression evaluation. The results were assessed before as well as 1, 3, 6 and 12 months after PTA.

Results: There were no differences at the baseline regarding to endothelial function between both groups. Neither FMD nor RHI changed after PTA in any of the groups, although there was a difference in median RHI value between CLI and non-CLI patients regarding the 1st and 6th month of the follow-up (RHI6–RHI1 = 0.08 in CLI and -0.15 in non-CLI; P = 0.01). The larger baseline intima-media (IMT) in the CLI group allowed to predict a greater number of reintervention (P = 0.01) and major adverse event rates (P = 0.03). CLI patients presented larger decrease in the Rutherford scale compared to non-CLI (P < 0.001).

Conclusions: Baseline IMT was predictive for re-interventions and major adverse event rates. Although neither of groups exhibited significant changes in endothelial function, we proved differences between them regarding to changes in RHI.

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Keywords

critical limb ischemia, endothelium, endovascular treatment, peripheral artery disease, revascularisation

About this article
Title

Endothelial function in patients with critical and non-critical limb ischemia undergoing endovascular treatment

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-05-18

DOI

10.33963/KP.a2021.0010

Pubmed

34002844

Keywords

critical limb ischemia
endothelium
endovascular treatment
peripheral artery disease
revascularisation

Authors

Paweł Kaczmarczyk
Marzena Frołow
Rafał Januszek
Andrzej Belowski
Iwona Gregorczyk-Maga
Stefan Chlopicki
Paweł Maga

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