Revascularização endovascular de membros inferiores: fatores determinantes na taxa de salvamento de membro

Abstract

Introduction: Atherosclerosis develops throughout life with gradual thickening of the walls of blood vessels. Peripheral arterial disease (PAD) is a progressive disease resulting from the evolution of atherosclerosis with obstructive limitation of multifactorial blood flow. The early diagnosis, therapy directed to associated beams and the availability of intervention allows a better quality of life. Objective: To evaluate the limb salvage rate of endovascular treatment in the iliac and infra-inguinal follow-up of patients with Perip-heral Obstructive Artery Disease treated in a University Hospital correlating the influence of risk factors. Material and Methods: Retrospective observational study of patients submitted to artery angioplasty at the iliac and infra-inguinal follow-up with or without stent implantation from January 2010 to June 2014. Results: Of the total of 100 patients, 58% were from the male, 87% white, 10% black and 3% mulatto, 77% had hypertension, 47% had DM 2, 28% had smoking, 42% had dyslipidemia; mean age was 66 years; 69% had ulceration or gangrene (FONTAINE Stage IV, RUTHERFOR Category 5 and 6); 89% of the patients had the initial diagnosis by Doppler ultrasonography; 16% had ste-noses in topography of iliac arteries; 19% of superficial femoral artery; 12% of popliteal artery; 24% infrapopliteo segment; in the iliac segment 22% underwent angioplasty with balloon catheter and 78% with angioplasty with stent implantation; in the femoro-popli-teo, 70% underwent angioplasty with balloon catheter, and 30% with stent implantation; underpopliteal, 80% underwent angioplasty with balloon catheter and 20% with stent im-plantation; mean ITB pre procedure, of 0.53, with the post procedure, of 0.84; 13% evol-ved to amputation and 6% evolved to death; only Diabete Melito presented statistical significance with amputation (95% CI, p 0.04). Conclusion: PAOD can progress to cri-tical ischemia and threaten the member's viability-functionality, quality of life and patient survival. Multifactorial treatment associated with pecutaneous endovascular disease should be prioritized for patients with PAD Fontaine III and IV, mainly diabetics, due to low morbidity and mortality and high technical success.