Effect of perioperative complications after endovascular therapy in patients with peripheral artery disease due to femoropopliteal lesions.
OBJECTIVE
Despite wide use, high initial success, and acceptable durability of endovascular therapy (EVT) for femoropopliteal (FP) lesions, the frequency of 30-day perioperative complications (POCs) and their effect on clinical outcomes have not been systematically evaluated, which is the subject of this study.


METHODS
We used a multicenter database of 2145 consecutive patients (70% male; overall mean age, 73 ± 9 years) who successfully underwent EVT for FP lesions to investigate independent predictors of POCs (logistic regression analysis) and effect of POCs on prognostic outcomes (Cox proportional regression).


RESULTS
POCs were observed in 209 patients (10%). In multivariate logistic regression analysis, body mass index <18.5 kg/m(2), critical limb ischemia, and TransAtlanic Inter-Society Consensus for the Management of Peripheral Arterial Disease class D lesions were independently associated with POCs (adjusted odds ratios [95% confidence intervals], 2.0 [1.3-2.9], 2.5 [1.9-3.3], and 1.6 [1.2-2.1], respectively). After risk stratification of POCs according to the number of these risk factors, the incidence of POCs was higher in the groups with higher scores. Follow-up for >30 days (mean, 2.3 ± 1.8 years) was available for 2079 of 2145 patients. A Cox hazard regression model adjusted for baseline clinical characteristics showed POCs were negatively and independently associated with future occurrence of major adverse limb events (defined as major amputation and major reintervention) or death (hazard ratio [95% confidence interval], 1.6 [1.2-2.1]; P < .05).


CONCLUSIONS
Body mass index <18.5 kg/m(2), critical limb ischemia, and TransAtlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease class D lesion were positively associated with POCs after EVT for FP lesions. The occurrence of POCs may adversely affect clinical outcomes in the chronic phase.
Department of Cardiology, Sakakibara Heart Institute, Fuchu, Japan; Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan. Electronic address: satokei715@gmail.com.
Kei
K
Sato
Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
Osamu
O
Iida
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Mitsuyoshi
M
Takahara
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Yoshimitsu
Y
Soga
Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan.
Kenji
K
Suzuki
Department of Cardiology, Matsusaka General Central Hospital, Matsusaka, Japan.
Takashi
T
Tanigawa
Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan.
Masaaki
M
Ito
Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
Masaaki
M
Uematsu
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D015992:Body Mass Index; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents