Angiographic follow-up and clinical outcome of 126 patients after percutaneous directional atherectomy (simpson atherocath™) for occlusive peripheral vascular disease

1991 ◽  
Vol 22 (2) ◽  
pp. 79-84 ◽  
Author(s):  
Gerald Dorros ◽  
Sriram Iyer ◽  
Ruben Lewin ◽  
Rafic Zaitoun ◽  
Lynne Mathiak ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Directional Atherectomy ◽  
Occlusive Peripheral Vascular Disease

P907Respective pronostic value of the valvular aortic calcifications and the thoracic aorta calcifications in patients with and without low gradient aortic stenosis after TAVI

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Harbaoui ◽  
G Souteyrand ◽  
T Lefevre ◽  
H Liebgott ◽  
P Y Courand ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Stenosis ◽  
Renal Insufficiency ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Cardiovascular Mortality ◽  
Chronic Respiratory Disease ◽  
Peripheral Vascular ◽  
History Of

Abstract Background Both the valvular aortic calcifications (VAC) and the thoracic aorta calcifications (TAC) have a prognostic impact in patients with aortic stenosis. Their respective prognostic values in patients with and without low gradient aortic stenosis (LGAS) remain unknown after TAVI. Objectives To assess the prognostic significance of VAC and TAC in patients with and without LGAS regarding cardiovascular mortality after 3 years follow-up. Methods The CAPRI-LGAS is an ancillary study of the C4CAPRI trial (NCT02935491) including 1282 consecutive TAVI patients. Calcifications were measured on pre-TAVI CT. The primary outcome was defined as cardiovascular mortality 3 years after TAVI. Results Among the 1282 patients, 397 (31%) had a LGAS. Compared to the other patients, LGAS patients were more prone to be men, younger, with atrial fibrillation, and lower left ventricular ejection fraction (LVEF), p<0.05 for all. No statistically significant difference was noticed for pulmonary systolic pressures, history of diabetes, chronic respiratory disease, renal insufficiency or peripheral vascular disease. VAC was lower in LGAS compared to non-LGAS patients (1.05 cm3±0.7 vs 0.75 cm3±0.5), p<0.001, the contrary was noticed for TAC, (3.1 cm3±3 vs 3.7 cm3±3.7), p=0.011. After 3 years follow-up, 227 (17.7%) patients died from cardiovascular causes; respectively 85 (21.4%) and 142 (16.1%) patients with and without LGAS, p=0.02. In univariate analysis, in LGAS patients each increase of 1cm3 TAC was associated with cardiovascular mortality while VAC was not, respectively Hazard Ratio (HR) 1.07 and confidence interval (CI) (1.023–1.119) p=0.003, and HR 0.822 CI (0.523–1.292), p=0.39. In patients without LGAS both TAC and VAC were associated with mortality, respectively HR 1.054 CI (1.006–1.104), p=0.028 and HR 1.363 CI (1.092–1.701), p=0.006. Multivariate analysis was adjusted for TAC, VAC, age, gender, atrial fibrillation, and LVEF. In LGAS patients TAC but not VAC was still a predictor of cardiovascular mortality, respectively HR 1.092 CI (1.031–1.158), p=0.003, and HR 0.743 CI (0.464–1.191), p=0.21. In patients without LGAS TAC was no more associated with cardiovascular mortality while VAC was, respectively HR 1.306 CI (1.024–1.666), p=0.031, and HR 1.038 CI (0.985–1.094), p=0.161. When further adjusting on pulmonary systolic pressures, history of diabetes, chronic respiratory disease, renal insufficiency and peripheral vascular disease, the results remained similar ie in LGAS patients, TAC HR 1.090 CI (1.022–1.162), p=0.009 while in patients without LGAS VAC HR 1.377 CI (1.049–1.809), p=0.021. Conclusions The present study shows that VAC and TAC involve different prognostic information in patients with and without LGAS after TAVI. While VAC may be a marker of early and periprocedural mortality and aortic regurgitation in non-LGAS patients, TAC may continue to be harmful and increase afterload in patients with LGAS whom LVEF is often impaired.

Predictors of mortality in patients with peripheral vascular disease. A prospective follow-up study

2004 ◽  
Vol 4 (3) ◽  
pp. 196-200 ◽  
Author(s):  
Constantinos G Missouris ◽  
Rigas G Kalaitzidis ◽  
Sally M Kerry ◽  
Francesco P Cappuccio
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Predictors Of Mortality ◽  
Follow Up Study
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