Cox proportional hazard model for influencing factors of restenosis after femoral endarterectomy in treatment of arteriosclerosis obliterans at femoral artery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Liqiang ,  GU Yongquan , TONG Zhu , ZHANG Jian , LI Jianxin , GUO Lianrui , CUI Shijun , QI Lixing

Department of Vascular Surgery, Xuanwu Hospital, Institute of Vascular Surgery, Capital Medical University, Beijing 100053, P. R. China;

Corresponding author：

GU Yongquan, Email: 15901598209@163.com

Keywords：

arteriosclerosis obliterans; femoral artery; femoral endarterectomy; restenosis; influencing factor

DOI：

10.7507/1007-9424.201703045

Video：

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Objective To investigate the influencing factors for restenosis after femoral endarterectomy in treatment of arteriosclerosis obliterans at femoral artery . Methods A total of 103 patients with arteriosclerosis obliterans at femoral artery who underwent femoral endarterectomy from Jan. 2012 to Jan. 2017 in our hospital were retrospectively selected as subjects of this study, to compare the clinical feathers between restenosis group and patent group, and then exploring the influencing factors for restenosis after femoral endarterectomy. Results Thirty-six patients (35.0%) suffered from restenosis after femoral endarterectomy. Patients in the restenosis group had a high proportion of high smoking and diabetes mellitus, and high level of low density lipoprotein than those corresponding indexes of the patent group (P<0.05). Results of Cox proportional hazard model showed that, diabetes mellitus 〔RR=3.338, 95% CI was (1.003, 11.113), P=0.049〕 and high level of low density lipoprotein 〔RR=3.311, 95% CI was (1.166, 9.397), P=0.024〕 were independent risk factors for restenosis after femoral endarterectomy. Conclusions Monitoring of high-risk factors like controlling blood glucose strictly and strengthening statin treatment should be done to reduce the risk of restenosis after femoral endarterectomy for patients with arteriosclerosis obliterans at femoral artery.

Citation： LI Liqiang, GU Yongquan, TONG Zhu, ZHANG Jian, LI Jianxin, GUO Lianrui, CUI Shijun, QI Lixing. Cox proportional hazard model for influencing factors of restenosis after femoral endarterectomy in treatment of arteriosclerosis obliterans at femoral artery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(9): 1071-1075. doi: 10.7507/1007-9424.201703045 Copy

1.	董智强, 李雪岩, 王忠臣, 等. 盐酸沙格雷酯预防下肢股动脉支架置入术后再狭窄的临床效果. 中国普外基础与临床杂志, 2014, 21(6): 727-730.
2.	王恒振, 魏争, 刘冰. 股动脉支架内再狭窄的腔内治疗进展. 中国血管外科杂志(电子版), 2016, 8(1): 93-96.
3.	谷涌泉. 下肢动脉硬化闭塞症腔内治疗的新进展. 中国普通外科杂志, 2014, 23(6): 719-723.
4.	Siracuse JJ, Van Orden K, Kalish JA, et al. Endovascular treatment of the common femoral artery in the vascular quality initiative. J Vasc Surg, 2017, 65(4): 1039-1046.
5.	谷涌泉, 郭连瑞, 郭建明, 等. SilverHawk 斑块切除联合紫杉醇药物球囊治疗下肢动脉慢性缺血. 中国微创外科杂志, 2017, 17(1): 65-68.
6.	谷涌泉, 郭连瑞, 齐立行, 等. 准分子激光消蚀联合药物球囊治疗下肢动脉慢性缺血 3 例. 介入放射学杂志, 2017, 26(1): 10-14.
7.	谷涌泉, 郭连瑞, 齐立行, 等. TurboHawk 斑块切除治疗伴严重钙化斑块的下肢动脉硬化闭塞症 2 例. 中国微创外科杂志, 2016, 16(5): 449-451.
8.	Malgor RD, Ricotta JJ 2^nd, Bower TC, et al. Common femoral artery endarterectomy for lower-extremity ischemia: evaluating the need for additional distal limb revascularization. Ann Vasc Surg, 2012, 26(7): 946-956.
9.	Siracuse JJ, Gill HL, Schneider DB, et al. Assessing the perioperative safety of common femoral endarterectomy in the endovascular era. Vasc Endovascular Surg, 2014, 48(1): 27-33.
10.	Ma T, Ma J. Femorofemoral bypass to the deep femoral artery for limb salvage after prior failed percutaneous endovascular intervention. Ann Vasc Surg, 2014, 28(6): 1463-1468.
11.	Silverberg D, Sheick-Yousif B, Yakubovitch D, et al. The deep femoral artery, a readily available inflow vessel for lower limb revascularization: a single-center experience. Vascular, 2013, 21(2): 75-78.
12.	刘昌伟, 管珩, 李拥军, 等. 骼动脉支架结合股深动脉成形术治疗高危重症下肢缺血的临床研究. 中国微创外科杂志, 2001, 1(4): 212-214.
13.	Dorweiler B, Friess T2, Duenschede F, et al. Value of the deep femoral artery as alternative inflow source in infrainguinal bypass surgery. Ann Vasc Surg, 2014, 28(3): 633-639.
14.	Hayes DJ Jr, Dougherty MJ, Calligaro KD. Management of flush superficial femoral artery occlusions with combined open femoral endarterectomy and endovascular femoral-popliteal angioplasty and stent-grafting. Ann Vasc Surg, 2011, 25(4): 559. e19-559. e23.
15.	Joh JH, Joo SH, Park HC. Simultaneous hybrid revascularization for symptomatic lower extremity arterial occlusive disease. Exp Ther Med, 2014, 7(4): 804-810.
16.	杨盛家, 谷涌泉, 佟铸, 等. 复合手术治疗累及腹股沟区股动脉的 TASCⅡD 型股腘动脉硬化闭塞症. 中国微创外科杂志, 2015, 15(9): 773-776, 797.
17.	Starodubtsev V, Karpenko A, Ignatenko P. Hybrid and open surgery of Trans-Atlantic Inter-SocietyⅡtype C and D iliac occlusive disease and concomitant lesion of common femoral artery. Int Angiol, 2016, 35(5): 484-491.
18.	Kechagias A, Ylönen K, Biancari F. Long-term outcome after isolated endarterectomy of the femoral bifurcation. World J Surg, 2008, 32(1): 51-54. .
19.	周兆熊, 张纪蔚. 股深动脉成形术——下肢动脉缺血治疗不能忽视的方法. 中国实用外科杂志, 2008, 28(10): 851-853.
20.	Nguyen BN, Amdur RL, Abugideiri M, et al. Postoperative complications after common femoral endarterectomy. J Vasc Surg, 2015, 61(6): 1489-1494. e1.
21.	刘丹, 方海龙, 刘华. 大隐静脉高位结扎及剥脱术后腹股沟切口淋巴瘘临床分析及文献回顾. 中国普外基础与临床杂志, 2010, 17(12): 1312-1313.
22.	Ando H, Suzuki A, Sakurai S, et al. Tissue characteristics of neointima in late restenosis: integrated backscatter intravascular ultrasound analysis for in-stent restenosis. Heart Vessels, 2017, 32(5): 531-538.
23.	Han B, Ge CQ, Zhang HG, et al. Effects of tripterygium glycosides on restenosis following endovascular treatment. Mol Med Rep, 2016, 13(6): 4959-4968.
24.	Tu QM, Wang ZW. Study on mechanism of c-Myc in restenosis after coronary artery bypass grafting. Eur Rev Med Pharmacol Sci, 2016, 20(11): 2363-2367.
25.	Weintraub WS. The pathophysiology and burden of restenosis. Am J Cardiol, 2007, 100(5A): 3K-9K.

1. 董智强, 李雪岩, 王忠臣, 等. 盐酸沙格雷酯预防下肢股动脉支架置入术后再狭窄的临床效果. 中国普外基础与临床杂志, 2014, 21(6): 727-730.
2. 王恒振, 魏争, 刘冰. 股动脉支架内再狭窄的腔内治疗进展. 中国血管外科杂志(电子版), 2016, 8(1): 93-96.
3. 谷涌泉. 下肢动脉硬化闭塞症腔内治疗的新进展. 中国普通外科杂志, 2014, 23(6): 719-723.
4. Siracuse JJ, Van Orden K, Kalish JA, et al. Endovascular treatment of the common femoral artery in the vascular quality initiative. J Vasc Surg, 2017, 65(4): 1039-1046.
5. 谷涌泉, 郭连瑞, 郭建明, 等. SilverHawk 斑块切除联合紫杉醇药物球囊治疗下肢动脉慢性缺血. 中国微创外科杂志, 2017, 17(1): 65-68.
6. 谷涌泉, 郭连瑞, 齐立行, 等. 准分子激光消蚀联合药物球囊治疗下肢动脉慢性缺血 3 例. 介入放射学杂志, 2017, 26(1): 10-14.
7. 谷涌泉, 郭连瑞, 齐立行, 等. TurboHawk 斑块切除治疗伴严重钙化斑块的下肢动脉硬化闭塞症 2 例. 中国微创外科杂志, 2016, 16(5): 449-451.
8. Malgor RD, Ricotta JJ 2^nd, Bower TC, et al. Common femoral artery endarterectomy for lower-extremity ischemia: evaluating the need for additional distal limb revascularization. Ann Vasc Surg, 2012, 26(7): 946-956.
9. Siracuse JJ, Gill HL, Schneider DB, et al. Assessing the perioperative safety of common femoral endarterectomy in the endovascular era. Vasc Endovascular Surg, 2014, 48(1): 27-33.
10. Ma T, Ma J. Femorofemoral bypass to the deep femoral artery for limb salvage after prior failed percutaneous endovascular intervention. Ann Vasc Surg, 2014, 28(6): 1463-1468.
11. Silverberg D, Sheick-Yousif B, Yakubovitch D, et al. The deep femoral artery, a readily available inflow vessel for lower limb revascularization: a single-center experience. Vascular, 2013, 21(2): 75-78.
12. 刘昌伟, 管珩, 李拥军, 等. 骼动脉支架结合股深动脉成形术治疗高危重症下肢缺血的临床研究. 中国微创外科杂志, 2001, 1(4): 212-214.
13. Dorweiler B, Friess T2, Duenschede F, et al. Value of the deep femoral artery as alternative inflow source in infrainguinal bypass surgery. Ann Vasc Surg, 2014, 28(3): 633-639.
14. Hayes DJ Jr, Dougherty MJ, Calligaro KD. Management of flush superficial femoral artery occlusions with combined open femoral endarterectomy and endovascular femoral-popliteal angioplasty and stent-grafting. Ann Vasc Surg, 2011, 25(4): 559. e19-559. e23.
15. Joh JH, Joo SH, Park HC. Simultaneous hybrid revascularization for symptomatic lower extremity arterial occlusive disease. Exp Ther Med, 2014, 7(4): 804-810.
16. 杨盛家, 谷涌泉, 佟铸, 等. 复合手术治疗累及腹股沟区股动脉的 TASCⅡD 型股腘动脉硬化闭塞症. 中国微创外科杂志, 2015, 15(9): 773-776, 797.
17. Starodubtsev V, Karpenko A, Ignatenko P. Hybrid and open surgery of Trans-Atlantic Inter-SocietyⅡtype C and D iliac occlusive disease and concomitant lesion of common femoral artery. Int Angiol, 2016, 35(5): 484-491.
18. Kechagias A, Ylönen K, Biancari F. Long-term outcome after isolated endarterectomy of the femoral bifurcation. World J Surg, 2008, 32(1): 51-54. .
19. 周兆熊, 张纪蔚. 股深动脉成形术——下肢动脉缺血治疗不能忽视的方法. 中国实用外科杂志, 2008, 28(10): 851-853.
20. Nguyen BN, Amdur RL, Abugideiri M, et al. Postoperative complications after common femoral endarterectomy. J Vasc Surg, 2015, 61(6): 1489-1494. e1.
21. 刘丹, 方海龙, 刘华. 大隐静脉高位结扎及剥脱术后腹股沟切口淋巴瘘临床分析及文献回顾. 中国普外基础与临床杂志, 2010, 17(12): 1312-1313.
22. Ando H, Suzuki A, Sakurai S, et al. Tissue characteristics of neointima in late restenosis: integrated backscatter intravascular ultrasound analysis for in-stent restenosis. Heart Vessels, 2017, 32(5): 531-538.
23. Han B, Ge CQ, Zhang HG, et al. Effects of tripterygium glycosides on restenosis following endovascular treatment. Mol Med Rep, 2016, 13(6): 4959-4968.
24. Tu QM, Wang ZW. Study on mechanism of c-Myc in restenosis after coronary artery bypass grafting. Eur Rev Med Pharmacol Sci, 2016, 20(11): 2363-2367.
25. Weintraub WS. The pathophysiology and burden of restenosis. Am J Cardiol, 2007, 100(5A): 3K-9K.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Cox proportional hazard model for influencing factors of restenosis after femoral endarterectomy in treatment of arteriosclerosis obliterans at femoral artery

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