ĐÁNH GIÁ KẾT QUẢ SỚM CAN THIỆP NỘI MẠCH TRONG ĐIỀU TRỊ TẮC HẸP ĐỘNG MẠCH DƯỚI GỐI MẠN TÍNH TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Introduction: Peripheral Artery Disease (PAD) is caused by atherosclerotic lesions that affect the blood supply to the legs, often leading to severe chronic limb ischemia (CLI). Below-knee artery disease (BKAD) accounts for 39.4% of patients, 97% with CLI symptoms1,2. The mortality rate is high, mainly due to cardiovascular events. The treatment of BKAD with CLI presents unique challenges, but with advances in technology and techniques, endovascular interventions are reducing open surgery rates and increasing technical and clinical success rates. Objectives: To evaluate short-term outcomes of below-knee endovascular interventions at Cho Ray Hospital. Methods: A retrospective descriptive study of a case series. Results: The study of 39 cases of chronic BKAD treated with endovascular intervention at Cho Ray Hospital can draw some conclusions as follows: The clinical characteristics of chronic BKAD patients are often found in the age group of 70-79, with men accounting for 53.9%, and the main risk factors being hypertension, smoking, diabetes, and dyslipidemia. The disease stage is mostly Rutherford 5; the average ABI before intervention is 0.36. Endovascular intervention in treating chronic BKAD is a safe and effective method, with a technical success rate of 90%, a 90.3% success rate in patients with ABI < 1.4, and a complication rate of 12.8%. After one year of intervention, the clinical success rate was 84.6%, the limb salvage rate was 92.1%, and the mortality rate was 10.3%. The clinical stage before intervention affects clinical success after the intervention; precisely, the more severe the clinical stage, the lower the clinical success rate. However, the degree of artery damage, severe calcification, or the number of foot arteries that are reperfused does not affect intervention outcomes. Conclusion:  Endovascular intervention is an effective and safe treatment method for patients with chronic BKAD. However, the disease stage and other clinical factors may affect intervention outcomes. Accurately assessing these factors is crucial in selecting the appropriate treatment method and achieving the best results for the patient.