Predictors of target lesion revascularization in patients undergoing lower extremity percutaneous interventions.
BACKGROUND
Predictors of target lesion revascularization (TLR) have not been well defined in patients undergoing peripheral percutaneous interventions (PPI). In this study we analyze predictors of TLR in a consecutive cohort of patients from two medical centers.


METHODS
Data were extracted from a prospectively collected peripheral vascular registry. Of 105 consecutive patients (175 vessels) undergoing PPI, follow up was achieved in 104 patients (172 vessels) at 8.06 +/- 4.51 months. Univariate analysis was performed between the groups with (n = 19, vessels = 25) and without (n = 85, vessels = 147) TLR. Logistic regression analysis was utilized to model for the predictors of TLR.


RESULTS
TLR occurred in 14% of vessels treated at 8.06 +/- 4.51 months. By univariate analysis, vessels with TLR on follow up had longer treated segments (167.0 +/- 139.16 mm vs. 98.49 +/- 113.33 mm; p = 0.027), more severe lesions (91.96 +/- 12.56% vs. 85.51 +/- 14.43%; p = 0.037) and were younger (63.0 +/- 10.1 years vs. 69.1 +/- 11.1 years; p = 0.032). Also, there was a trend toward a higher hs-CRP (11.35 +/- 17.85 vs. 7.45 +/- 9.57 mg/L) and more total occlusions (44.0% vs. 22.6%) in the TLR group, but these did not reach statistical significance. Logistic regression analysis with backward elimination including all these variables showed that younger age (p = 0.007), female gender (p = 0.033) and treated vessel length (p = 0.028) were the only independent predictors of TLR.


CONCLUSIONS
Younger age, female gender and longer treated vessel length are independent predictors of TLR in patients undergoing PPI. The cost-effectiveness in treating these patients with PPI versus surgery needs to be defined in future studies.
Shammas
Nicolas W
NW
Midwest Cardiovascular Research Foundation, Davenport, Iowa, USA. shammas@mchsi.com
Shammas
Gail
G
Bryan
Darren
D
Rauba
Jason
J
Dippel
Eric
E
Jerin
Michael
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D015936:Complement C5a / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D023903:Coronary Restenosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D005121:Extremities / Q000098:blood supply*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D015936:Complement C5a; D005340:Fibrinogen; D002097:C-Reactive Protein