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Int J Angiol 2015; 24(02): 137-142
DOI: 10.1055/s-0035-1547516
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preliminary Report of Endovascular Treatment for Critical Limb Ischemia Patients with Connective Tissue Disease: Cases Series and Review of the Literature

Hideaki Obara
1   Department of Surgery, Keio University School of Medicine, Tokyo, Japan
,
Kentaro Matsubara
1   Department of Surgery, Keio University School of Medicine, Tokyo, Japan
,
Naoki Fujimura
1   Department of Surgery, Keio University School of Medicine, Tokyo, Japan
,
Yasuhito Sekimoto
1   Department of Surgery, Keio University School of Medicine, Tokyo, Japan
,
Yuko Kitagawa
1   Department of Surgery, Keio University School of Medicine, Tokyo, Japan
› Author Affiliations
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Publication History

Publication Date:
23 March 2015 (online)

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Abstract

Only few studies have addressed the surgical revascularization in patients with both connective tissue disease (CTD) and critical limb ischemia (CLI), and the evidence for the endovascular treatment (EVT) is lacking in such patients. The main purpose of this study is to assess our outcome of EVT in patients with CTD and ischemic leg ulcers and review the current situation of the revascularization in such patients. Medical records of 10 consecutive patients with coexistent CTD and CLI-related leg ulcers (in 11 limbs) treated endovascularly at our institution between 2009 and 2013 were reviewed retrospectively. The patients had rheumatoid arthritis (n = 5), systemic lupus erythematosus (n = 1), progressive systemic scleroderma (n = 3), or polyarteritis nodosa (n = 1). EVT was technically successful in all the cases. No procedure-related morbidity or mortality occurred. During the mean follow-up period of 26 months, there were no major amputations, and sustained clinical improvement (ulcer healing and reduction in Rutherford category) was observed in eight limbs. The overall 1-year rates of amputation-free survival and freedom from reintervention were 89 and 81%, respectively. In our series of patients with CTD and ischemic leg ulcers, EVT had acceptable outcomes and may be recommended as a safe and reasonably effective initial treatment option for such patients.

Keywords

endovascular treatment - critical limb ischemia - connective tissue disease - rheumatoid arthritis - scleroderma
 

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