Author + information
- Received August 15, 2016
- Revision received October 12, 2016
- Accepted October 20, 2016
- Published online January 16, 2017.
- Makoto Utsunomiya, MD, PhDa,∗ (, )
- Mitsuyoshi Takahara, MDb,c,
- Osamu Iida, MDd,
- Yasutaka Yamauchi, MDe,
- Daizo Kawasaki, MDf,
- Yoshiaki Yokoi, MD, PhDg,
- Yoshimistu Soga, MDh,
- Norihiko Ohura, MDi,
- Masato Nakamura, MD, PhDj,
- OLIVE Investigators
- aDivision of Cardiovascular Medicine, Tokyo Rosai Hospital, Tokyo, Japan
- bDepartment of Metabolic Medicine Graduate School of Medicine, Osaka University, Osaka, Japan
- cDepartment of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- dCardiovascular Division, Kansai Rosai Hospital, Amagasaki, Japan
- eCardiovascular Center, Kikuna Memorial Hospital, Yokohama, Japan
- fCardiovascular Center, Morinomiya Hospital, Osaka, Japan
- gDepartment of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
- hDepartment of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
- iDepartment of Plastic and Reconstructive Surgery, School of Medicine, Kyorin University, Mitaka, Japan
- jDivision of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan
- ↵∗Reprint requests and correspondence:
Dr. Makoto Utsunomiya, Division of Cardiovascular Medicine, 4-13-21 Omori-minami, Ohta-ku, Tokyo, Japan 143-0013.
Objectives This study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing.
Background Several reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear.
Methods We conducted a subanalysis of the prospective multicenter OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia) registry investigation assessing patients who received infrainguinal EVT for CLI. We analyzed data from 185 limbs with ischemic ulcerations classified as Rutherford class 5 or 6, managed with EVT alone (i.e., not undergoing bypass surgery). The wound healing rate after EVT was estimated by the Kaplan-Meier method. The association between final angiographic data and wound healing was assessed employing a Cox proportional hazards model.
Results The overall wound healing rate was 73.5%. The probabilities of wound healing in patients with wound blush obtainment was significantly higher than that of those without wound blush (79.6% vs. 46.5%; p = 0.01). In the multivariate analysis, wound blush obtainment was an independent predictor of wound healing.
Conclusion The presence of wound blush after EVT is significantly associated with wound healing. Wound blush as an angiographic endpoint for EVT may serve as a novel predictor of wound healing in patients with CLI.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 15, 2016.
- Revision received October 12, 2016.
- Accepted October 20, 2016.
- American College of Cardiology Foundation