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Contralateral symptoms after unilateral intervention for peripheral occlusive disease
S O de Vries1, M C Donaldson, M G Hunink
1Department of Health Sciences, University of Groningen, The Netherlands.
Journal of Vascular Surgery
|April 18, 1998
Summary
Peripheral arterial occlusive disease often affects both limbs. Patients with prior ipsilateral critical ischemia or a low contralateral ankle-brachial index face a higher risk of developing symptoms in the other limb.
Area of Science:
- Vascular Surgery
- Peripheral Arterial Disease Research
- Epidemiology of Limb Ischemia
Background:
- Peripheral arterial occlusive disease (PAOD) significantly impacts patient mobility and quality of life.
- Unilateral interventions are common, but the long-term implications for the contralateral limb are not fully understood.
Purpose of the Study:
- To determine the incidence of contralateral symptoms following unilateral intervention for PAOD.
- To identify predictive factors for the development of contralateral symptoms in PAOD patients.
Main Methods:
- Retrospective analysis of 532 patients undergoing unilateral intervention for PAOD (1990-1995).
- Outcome measure: first occurrence of contralateral critical ischemia or intermittent claudication.
- Cox regression analysis used to identify predictive characteristics.
Main Results:
- Annual incidence of contralateral critical ischemia ranged from 3.3% to 8.3% in the first 4 years.
- Combined annual incidence of contralateral critical ischemia and claudication varied from 7.7% to 21.3%.
- Initial ipsilateral symptoms and contralateral ankle-brachial index were significant predictors.
Conclusions:
- PAOD is fundamentally a bilateral disease, necessitating a two-limb approach.
- Patients with prior ipsilateral critical ischemia and low contralateral ankle-brachial index are at elevated risk for contralateral critical ischemia.