Details

Autor(en) / Beteiligte

• Ruzsa, Zoltán
• Berta, Balázs
• Tóth, Júlia
• Nemes, Balázs
• Katona, András
• Hüttl, Arthúr
• Ungi, Imre
• Bertrand, Olivier F.
• Merkely, Béla

Titel

Short‐ and long‐term results with a percutaneous treatment in critical hand ischaemia

Ist Teil von

• Catheterization and cardiovascular interventions, 2019-06, Vol.93 (7), p.1301-1310

Ort / Verlag

Hoboken, USA: John Wiley & Sons, Inc

Erscheinungsjahr

2019

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Background The aim of this prospective registry was to determine the feasibility, safety, and outcomes of percutaneous transluminal angioplasty and thrombolysis in the treatment of critical hand ischemia (CHI). Methods One‐hundred one patients (aged 60.6 ± 15.3 years) were treated for CHI between 2012 and 2016 in three cardiovascular centers. Anatomically, the upper arm was divided into three segments (I‐subclavian, II‐brachial, and III‐forearm). We examined the rates of technical and clinical success, major adverse events (MAEs), and vascular complications at 1 year and at long‐term follow‐up. Results Nineteen patients (18.8%) were treated for acute CHI, and 82 (81.2%) for chronic CHI. Median follow‐up was 36.9 (19.6–68.3) months. Clinical symptoms were isolated rest pain in 91 patients (90.1%) and digital ulcer or gangrene in 10 patients (9.9%). The technical and clinical success rate of intervention was 96.0% (97/101) and 84.2% (85/101) at 1 year. Angioplasty was performed in Segments I, II, and III in 28 (27.7%), in 29 (28.7%), and 44 (43.5%) patients. Stent implantation was necessary in 47 patients (46.8%). Vascular access site complications were found in 2.1% of the sample. After 1 year, MAEs occurred in 27 patients (26.9%), and the target lesion revascularization rate was 11.9%. In two patients (1.9%), thoracic sympatectomy was necessary, and two patients (1.9%) underwent minor finger amputations. Conclusions Angioplasty of hand vessels for CHI is a feasible and safe procedure with acceptable rates of technical success and hand healing. MAEs are frequent because the rate of severe comorbidities is high.