VAI TRÒ PHÂN ĐỘ GLASS TRONG ĐIỀU TRỊ THIẾU MÁU MẠN TÍNH ĐE DỌA CHI

Abstract

Introduction: Treatment of Peripheral arterial disease (PAD) or chronic arterial occlusive disease of lower extremities by recanalization which is bypass surgery or endovascular intervention with the “golden” goal of re-establishing flow and preserving the limb. To select the treatment plan for each specific case, the Vascular Surgery Society (SVS) has set out criteria such as Patient risk, Limb status and Anatomical pattern, collectively written as PLAN. In addition, the GLASS (Global Limb Anatomical Staging System) classification has shown the concept of Target Artery Path (TAP) and the ability to maintain TAP recanalization after intervention (Limb-based patency). Objectives: Evaluation of the technical success and clinical outcomes of limb salvage by GLASS scoring system. Methods: Retrospective study describes a series of cases. Results: The study sample with 82 lower limbs was surveyed on 82 patients at the Department of Thoracic and Vascular Surgery, University Medical Center Ho Chi Minh City from June 2020 to June 2022. In which, lesions of GLASS class I, II and III accounted for 36.6%, 43.9% and 19.5%, respectively. The rate of technically successful intervention in the group that gradually decreased according to the complexity of the lesion was 90%, 86.11% and 56.25%, respectively. Besides GLASS III lesions, vascular calcification, total occlusion, and P2 foot/subankle perfusion are also predictive factors for failure of endovascular interventions. Conclusions: The higher of GLASS classification of patients with chronic limb threatening ischemia, the higher rate of successful endovascular intervention efficiency, lower rate of limb preservation, higher complication rates of intraprocedural intervention.