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Skin Perfusion Pressure Predicts Early Wound Healing After Endovascular Therapy in Chronic Limb Threatening Ischaemia

Authors
 Yong-Joon Lee  ;  Chul-Min Ahn  ;  Young-Guk Ko  ;  Kwang H Park  ;  Jin W Lee  ;  Seung-Jun Lee  ;  Sung-Jin Hong  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
Citation
 EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Vol.62(6) : 909-917, 2021-12 
Journal Title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
ISSN
 1078-5884 
Issue Date
2021-12
MeSH
Aged ; Aged, 80 and over ; Angioplasty, Balloon* / adverse effects ; Blood Pressure* ; Chronic Disease ; Female ; Humans ; Ischemia / diagnosis ; Ischemia / physiopathology ; Ischemia / therapy* ; Lower Extremity / blood supply* ; Male ; Middle Aged ; Peripheral Arterial Disease / diagnosis ; Peripheral Arterial Disease / physiopathology ; Peripheral Arterial Disease / therapy* ; Re-Epithelialization ; Regional Blood Flow ; Retrospective Studies ; Skin / blood supply* ; Time Factors ; Treatment Outcome ; Wound Healing*
Keywords
Chronic limb threatening ischaemia ; Endovascular therapy ; Skin perfusion pressure ; Wound healing
Abstract
Objective: Skin perfusion pressure (SPP) has been proposed as a method to predict wound healing in chronic limb threatening ischaemia (CLTI). However, studies regarding the impact of SPP before and after endovascular therapy (EVT) on wound healing are limited. This study sought to evaluate the predictive value of SPP for early wound healing in CLTI treated by EVT.

Methods: Between January 2018 and June 2020, 236 limbs (172 patients) with CLTI that underwent SPP measurement before and after EVT were included. SPP was measured before and 24 - 48 hours after the procedure. Early wound healing was defined as the achievement of complete epithelisation of all wounds without major amputation within three months of EVT.

Results: Early wound healing was achieved in 145 (61.4%) limbs after EVT. Baseline SPP (44.1 ± 21.0 mmHg vs. 33.5 ± 21.7 mmHg; p < .001) and post-procedural SPP (61.8 ± 18.5 mmHg vs. 37.4 ± 19.9 mmHg; p < .001) were significantly higher in the wound healing (+) group than in the wound non-healing (-) group. The area under the receiver operating characteristics curve for early wound healing was 0.82 for post-procedural SPP with a cutoff value of 50 mmHg (sensitivity 74.5%, specificity 78.0%). The early wound healing rate was significantly higher with a post-procedural SPP ≥ 50 mmHg compared with a SPP < 50 mmHg (84.4% vs. 35.0%; p < .001).

Conclusion: Post-procedural SPP with a cutoff value of 50 mmHg was capable of predicting early wound healing after EVT in CLTI.
Full Text
https://www.sciencedirect.com/science/article/pii/S1078588421006900?via%3Dihub
DOI
10.1016/j.ejvs.2021.08.030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Park, Kwang Hwan(박광환) ORCID logo https://orcid.org/0000-0002-2110-0559
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Lee, Seung-Jun(이승준) ORCID logo https://orcid.org/0000-0002-9201-4818
Lee, Yong Joon(이용준)
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187590
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