title: Predictors of target lesion revascularization in patients undergoing lower extremity percutaneous interventions.
abstract: 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.
authors.affiliation: Midwest Cardiovascular Research Foundation, Davenport, Iowa, USA. shammas@mchsi.com
authors.forename: Nicolas W
authors.initials: NW
authors.lastname: Shammas
authors.forename: Gail
authors.initials: G
authors.lastname: Shammas
authors.forename: Darren
authors.initials: D
authors.lastname: Bryan
authors.forename: Jason
authors.initials: J
authors.lastname: Rauba
authors.forename: Eric
authors.initials: E
authors.lastname: Dippel
authors.forename: Michael
authors.initials: M
authors.lastname: Jerin
mesh_terms: 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
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D015936:Complement C5a; D005340:Fibrinogen; D002097:C-Reactive Protein