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Increased thrombogenicity is associated with revascularization outcomes in patients with chronic limb-threatening

Naoto Kuyama1, Koichi Kaikita2, Masanobu Ishii1

  • 1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Journal of Vascular Surgery
|April 7, 2022
PubMed

Insights

The atheroma chip test (AR10-AUC30) can predict revascularization after endovascular therapy in chronic limb-threatening ischemia (CLTI) patients. This suggests hypercoagulability contributes to CLTI progression, potentially benefiting from anticoagulant therapy.

Area of Science:

  • Vascular Medicine
  • Thrombosis Research
  • Interventional Cardiology

Background:

  • Clinically driven target lesion revascularization (CD-TLR) is common after endovascular therapy (EVT) for chronic limb-threatening ischemia (CLTI).
  • Quantitative thrombogenicity assessment using the total thrombus-formation analysis system (T-TAS) may predict CD-TLR.
  • Understanding T-TAS parameters' association with CD-TLR is crucial for optimizing CLTI management.

Purpose of the Study:

  • To investigate the association between T-TAS parameters and CD-TLR in patients undergoing EVT.
  • To determine if T-TAS can predict the need for revascularization in CLTI patients post-EVT.
  • To explore the role of hypercoagulability in CLTI progression and its impact on revascularization outcomes.

Main Methods:

  • Analysis of 34 CLTI patients and 62 non-CLTI patients who underwent EVT.
  • Measurement of platelet chip (PL24-AUC10) and atheroma chip (AR10-AUC30) parameters using T-TAS.
  • Clinical follow-up to assess CD-TLR, with statistical analysis including multivariable Cox regression and ROC curve analysis.

Main Results:

  • In CLTI patients, higher AR10-AUC30 was significantly associated with CD-TLR (P=.01).
  • AR10-AUC30 independently predicted CD-TLR in CLTI patients (HR, 2.04; P=.01).
  • An AR10-AUC30 cutoff of 1646 predicted CD-TLR with high sensitivity (0.93) and AUC (0.85).

Conclusions:

  • The AR10-AUC30 parameter from T-TAS shows potential for predicting CD-TLR in CLTI patients.
  • Hypercoagulability may play a significant role in CLTI progression.
  • Anticoagulant therapy could be beneficial in preventing revascularization in CLTI patients.
Abstract

Keywords:
AR(10)-AUC(30)Chronic limb-threatening ischemiaT-TASTarget lesion revascularization

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