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

Zoltán Ruzsa1,2, Balázs Berta1, Júlia Tóth2

  • 1Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 31, 2019
PubMed

Insights

Percutaneous transluminal angioplasty is a feasible and safe treatment for critical hand ischemia (CHI), demonstrating high technical success and hand healing rates. Major adverse events (MAEs) are common due to patient comorbidities.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Peripheral Artery Disease

Background:

  • Critical hand ischemia (CHI) poses significant challenges for limb salvage.
  • Percutaneous transluminal angioplasty and thrombolysis offer potential treatment options.

Purpose of the Study:

  • To assess the feasibility, safety, and outcomes of endovascular treatment for CHI.
  • To evaluate technical success, clinical success, and complication rates.

Main Methods:

  • Prospective registry of 101 patients with CHI treated between 2012-2016.
  • Angioplasty performed across three upper arm segments (subclavian, brachial, forearm).
  • Assessment of technical/clinical success, major adverse events (MAEs), and complications at 1 year and long-term follow-up.

Main Results:

  • High technical success (96.0%) and 1-year clinical success (84.2%) rates.
  • Angioplasty targeted forearm vessels in 43.5% of cases; stenting in 46.8%.
  • 1-year MAE rate was 26.9%, with low vascular access site complications (2.1%).

Conclusions:

  • Endovascular angioplasty is a feasible and safe approach for treating CHI.
  • Acceptable rates of technical success and hand healing were observed.
  • High rates of MAEs are attributed to the prevalence of severe comorbidities in CHI patients.
Abstract

Keywords:
balloon angioplastybrachial/radial/ulnarcatheterizationcomplicationsvascular access

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