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The treatment effect of endovascular therapy for chronic limb-threatening ischemia with systemic sclerosis

Yoshihiro Matsuda1, Tomoko Miyake1, Hironobu Toda2

  • 1Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

The Journal of Dermatology
|June 19, 2024
PubMed

Insights

Systemic sclerosis (SSc) patients with chronic limb-threatening ischemia (CLTI) showed similar outcomes to those without SSc after revascularization. Treatment should consider infection and general condition for improved pain relief in SSc-CLTI cases.

Area of Science:

  • Vascular Surgery
  • Rheumatology
  • Dermatology

Background:

  • Systemic sclerosis (SSc) is a fibrotic collagen disease with immune and vascular involvement.
  • Chronic limb-threatening ischemia (CLTI) presents with extremity ulcers, necrosis, and pain due to poor blood flow.
  • The combined presentation of CLTI and SSc is rare, leaving treatment outcomes for revascularization unclear.

Purpose of the Study:

  • To evaluate clinical characteristics and treatment outcomes of patients with coexisting CLTI and SSc.
  • To compare these outcomes with patients suffering from uncomplicated CLTI.

Main Methods:

  • Retrospective analysis of seven CLTI and SSc patients and 35 uncomplicated CLTI patients hospitalized between 2012 and 2022.
  • Comparison of demographics, comorbidities, and treatment interventions including revascularization and amputation.
  • Assessment of outcomes such as epithelialization, pain relief, and survival time.

Main Results:

  • Patients with uncomplicated CLTI had higher rates of diabetes and male gender.
  • No significant differences were observed in age of ulceration, comorbidities, or treatments (antimicrobials, revascularization, amputation).
  • Among CLTI and SSc patients undergoing endovascular therapy (EVT), 33% achieved epithelialization and 67% experienced pain relief.

Conclusions:

  • Revascularization in CLTI and SSc patients can improve pain.
  • Treatment decisions for CLTI and SSc should carefully consider infection and the patient's overall condition.
  • Further research is needed to optimize revascularization strategies for this rare patient group.

Keywords:
chronic limb‐threatening ischemia (CLTI)endovascular therapy (EVT)revascularizationsystemic sclerosis (SSc)

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