Body mass index and long-term outcomes in patients with chronic total occlusions undergoing retrograde endovascular revascularization of the infra-inguinal lower limb arteries

摘要

BACKGROUND:The aim of the present study is to assess the relationship between body mass index (BMI) and long-term clinical outcomes in retrograde endovascular recanalization (ER) regarding chronic total occlusions (CTOs) of the infra-inguinal lower limb arteries.METHODS:The study included patients who underwent retrograde ER of CTOs localized in superficial, popliteal or below-the-knee arteries. During follow-up, major adverse cardiac and cerebrovascular (MACCE) and major adverse lower limb events were evaluated (MALE). MALE was defined as amputation, target lesion re-intervention, target vessel re-intervention and surgical treatment.RESULTS:The study included 405 patients at the mean age of 67.2 ± 10.4. The authors divided the overall group of patients according to BMI into 25 (n = 156, 38.5%) and ≥ 25 kg/m2 (n = 249, 61.5%), and then into 30 (n = 302, 75.8%) and ≥ 30 kg/m2 (n = 103, 24.2%). During the average follow-up 1,144.9 ± 664.3 days, the mortality rate was higher in the group of patients with BMI 25 kg/m2 (10.5% vs. 5.3%, p = 0.051), and in the group of patients with BMI 30 kg/m2 (8.7% vs. 2.9%, p = 0.048). The comparison of Kaplan-Meier curves revealed borderline differences when assessing months to death for the BMI 25 kg/m2 (p = 0.057) and BMI 30 kg/m2 (p = 0.056) grouping variables.CONCLUSIONS:Obese and overweight patients undergoing CTO ER of the lower limb arteries from retrograde access are related to lower death rates during long-term follow-up.