重症虚血肢に対する治療成績の検討

宮原 拓也; 須原 正光; 根元 洋光; 白須 拓郎; 芳賀 真; 望月 康晃; 松倉 満; 赤井 隆文; 谷口 良輔; 根本 卓; 山本 諭; 西山 綾子; 保坂 晃弘; 保科 克行; 岡本 宏之; 重松 邦広; 宮田 哲郎; 渡邉 聡明

doi:10.7133/jca.13-00044

Original Articles

Long-term Results of Treatment for Critical Limb Ischemia

Takuya Miyahara, Masamitsu Suhara, Yoko Nemoto, Takuro Shirasu, Makoto Haga, Yasuaki Mochizuki, Mitsuru Matsukura, Takafumi Akai, Ryosuke Taniguchi, Masaru Nemoto, Satoshi Yamamoto, Nishiyama Ayako, Akihiro Hosaka, Katsuyuki Hoshina, Hiroyuki Okamoto, Kunihiro Shigematsu, Tetsuro Miyata, Toshiaki Watanabe

Author information

Takuya Miyahara
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Masamitsu Suhara
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Yoko Nemoto
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Takuro Shirasu
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Makoto Haga
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Yasuaki Mochizuki
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Mitsuru Matsukura
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Takafumi Akai
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Ryosuke Taniguchi
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Masaru Nemoto
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Satoshi Yamamoto
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Nishiyama Ayako
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Akihiro Hosaka
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Katsuyuki Hoshina
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Hiroyuki Okamoto
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Kunihiro Shigematsu
Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan
Tetsuro Miyata
Vascular Center, Sanno Medical Center, International University of Health and Welfare, Tokyo, Japan
Toshiaki Watanabe
Surgical Oncology, Department of Surgery, The University of Tokyo, Tokyo, Japan

Keywords: arteriosclerosis obliterans, peripheral arterial disease, critical limb ischemia, arterial reconstruction

JOURNAL OPEN ACCESS

2014 Volume 54 Issue 2 Pages 5-11

DOI https://doi.org/10.7133/jca.13-00044

Details

Abstract

From 2001 to 2012, arterial reconstruction was performed in 306 out of 497 limbs (62%) with critical limb ischemia. The reasons for non-vascularization include high operative risk (36%), extended necrosis or infection (20%), and technical issues (15%). Cumulative patency and limb salvage in collagen disease were significantly worse compared to arteriosclerosis obliterans. Cumulative limb salvage, amputation free survival (AFS), and major adverse limb event and perioperative death (MALE+POD) in patients with end-stage renal disease (ESRD) were significantly worse compared to patients without ESRD, but not significant with regards to graft patency. Our finding suggests that aggressive arterial reconstruction provides satisfactory long-term results in critical limb ischemia so long as case selection for revascularization is properly made.

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