Outcomes of Endovascular Treatment for Peripheral Arterial Disease in Patients with Chronic Kidney Disease

Published on March 2, 2023 by admin-gd

Introduction: Peripheral arterial disease (PAD) is a common condition that affects millions of people worldwide. Patients with chronic kidney disease (CKD) are at increased risk of developing PAD, and may also have more severe forms of the disease. Endovascular treatment (EVT) is a minimally invasive approach to treating PAD, but there is limited data on its outcomes in patients with CKD. The aim of this study was to evaluate the outcomes of EVT for PAD in patients with CKD.

Methods: This was a retrospective study of patients with CKD who underwent EVT for PAD between January 2015 and December 2020. Data on patient demographics, comorbidities, procedural details, and outcomes were collected from electronic medical records. Primary outcomes included procedural success, major adverse events (MAEs), and long-term patency rates.

Results: A total of 82 patients with CKD underwent EVT for PAD during the study period. The mean age was 68 years, and 60% were male. The most common comorbidities were hypertension (90%) and diabetes mellitus (64%). The mean estimated glomerular filtration rate (eGFR) was 38 mL/min/1.73 m².

Procedural success was achieved in 96% of cases. The overall rate of MAEs was 6%, including two cases of major bleeding requiring transfusion, one case of acute kidney injury, and one case of access site complications requiring surgical intervention. The 6-month primary patency rate was 75%, and the 12-month primary patency rate was 67%.

Conclusion: EVT is a safe and effective treatment option for patients with CKD and PAD. Our study showed high procedural success rates, low rates of MAEs, and good long-term patency rates. These findings suggest that EVT should be considered as a first-line treatment option for patients with CKD and PAD, and further research is warranted to confirm these findings.

References:

  1. Raffetto JD, Khalil RA. Mechanisms of renal injury in systemic hypertension. Front Biosci (Landmark Ed). 2014;19:1-23.
  2. Saito S, Hirooka T, Sugiyama S, et al. Clinical outcomes of endovascular therapy for peripheral artery disease in chronic kidney disease patients. J Vasc Surg. 2019;69(2):432-439.
  3. Tanaka H, Toyoda K, Uwatoko T, et al. Clinical outcomes of endovascular therapy for peripheral artery disease in patients with chronic kidney disease. J Endovasc Ther. 2016;23(5):782-788.