title: Infrainguinal Endovascular Recanalization: Risk Factors for Arterial Thromboembolic Occlusions and Efficacy of Percutaneous Aspiration Thrombectomy.
abstract: OBJECTIVE
  To investigate factors predictive of thromboembolic occlusions and evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal thromboembolic occlusions in patients undergoing endovascular recanalization (EVR).
  
  
  METHODS
  In this single-center retrospective study, 23 patients who underwent PAT for thromboembolism during EVR and 237 patients who underwent successful EVR without thromboembolic occlusions (control group) were enrolled. Immediate posttreatment and follow-up outcomes between groups were compared. Multivariate analysis was performed to identify factors predictive of thromboembolic occlusions. Technical success of PAT was defined as achievement of < 30% residual stenosis and restoration of modified thrombolysis in myocardial infarction grade 3 flow.
  
  
  RESULTS
  The technical success rate was 95.7% in the PAT group. After intervention, ankle brachial index (ABI), restoration of blood flow, and improvement in dorsal/plantar arterial pulse score showed no significant differences between the PAT and control groups. During follow-up, no significant differences were observed between groups in improvement of sustained ABI and maximum walking distance, ulcer healing, restenosis/occlusion and limb salvage rates, and pain relief in patients with critical ischemia. Stenosis greater than 90% with lesion occlusion (odds ratio, 12.891; 95% confidence interval, 1.676-99.161; P = .014) and intraluminal angioplasty (odds ratio, 18.423; 95% confidence interval, 2.408-140.942; P = .005) were associated with a high incidence of thromboembolism.
  
  
  CONCLUSIONS
  Stenosis greater than 90% with lesion occlusion and intraluminal angioplasty may be factors predictive of thromboembolic occlusions. PAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR.
authors.affiliation: Department of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China.
authors.forename: Yueqi
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China.
authors.forename: Peilei
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China.
authors.forename: Xiaocong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China. Electronic address: zhaojungong6th@hotmail.com.
authors.forename: Jungong
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yi Shan Road, Shanghai 200233, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Lu
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D017130:Angioplasty / Q000009:adverse effects*; D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012039:Regional Blood Flow; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D017131:Thrombectomy / Q000009:adverse effects; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency