A comparative outcome of infrainguinal vessel endovascular intervention by intravascular ultrasound-guided (IVUS) versus angiography-guided in chronic limb-threatening ischemia at Phramongkutklao hospital
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Abstract
A comparative outcome of infrainguinal vessel endovascular intervention by intravascular ultrasound-guided (IVUS) versus angiography-guided in chronic limb-threatening ischemia at Phramongkutklao hospital
Objective : Chronic limb-threatening ischemia make many patients loss limbs world wild. Treatment strategy for this disease is important. The endovascular treatment-first strategy (EVT) are prefer.Today, intravascular ultrasound was developed for evaluation more vessel pathology detail. It give more information during endovascular surgery. The aims of study is to prove outcome of intravascular ultrasound (IVUS) guide endovascular intervention comparison with angiographic guide endovascular intervention in chronic limb-threatening ischemia at Phramongkutklao hospital.
Method : Single center, retrospective cohort study was created. Data were collected since January 2018 to December 2022. The data of chronic limb-threatening ischemia patients who were operated by endovascular surgery were collected. Then separate into 2 group, The control group is angiographic guide endovascular intervention and the study group is IVUS guide endovascular intervention. Major adverse limb events (MALE) in 6 month and major adverse cardiac events (MACE) in 30 days are primary outcome of this study.
Result : 98 limb of 90 patients were included. Angiographic guide endovascular intervention is 69 limb. And IVUS guide endovascular intervention is 29 limb. They were not difference in patient baseline characteristic and severity of disease. Overall technical success rates are 100%. After calculate by Chi-Square Tests, 6 month MALE are equal in both group ( angiography 20.3% vs IVUS 20.7%; p=0.964). Similar in 30 day MACE, the result are not difference in both group ( angiography 8.7% vs IVUS 10.3%; p=0.796)
Conclusion : IVUS guide endovascular intervention do not increase limb salvage rate than angiographic guide in short term outcome. Other benefit of this imaging technique such as post angioplasty dissection detection rate and accurately stent size selection must be study more in large population.
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References
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