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Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease

Objective: Endovascular treatment (EVT) for lower-limb peripheral artery disease patients reduces blood pressure (BP) and improves prognosis. This study retrospectively examined hemodynamics during EVT to clarify the mechanism. Materials and Methods: Systemic vascular resistance (SVR) was measured u...

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Detalles Bibliográficos
Autores principales: Nomoto, Hidetsugu, Nozato, Toshihiro, Yamashita, Shu, Suzuki, Masahito, Sugiyama, Tomoyo, Oumi, Tetsuo, Ohno, Masakazu, Shimizu, Shigeo, Ashikaga, Takashi, Satoh, Yasuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758593/
https://www.ncbi.nlm.nih.gov/pubmed/33391554
http://dx.doi.org/10.3400/avd.oa.20-00086
Descripción
Sumario:Objective: Endovascular treatment (EVT) for lower-limb peripheral artery disease patients reduces blood pressure (BP) and improves prognosis. This study retrospectively examined hemodynamics during EVT to clarify the mechanism. Materials and Methods: Systemic vascular resistance (SVR) was measured using a noninvasive continuous cardiac output monitoring system during EVT. Furthermore, ankle brachial index was measured before and after EVT. Results: The study included 88 lesions of 56 patients (hypertension in 98%). SVR significantly decreased from 2409.1±746.8 dynes·s·cm(−5) to 2033.7±635.0 dynes·s·cm(−5) (p<0.0001). The difference in SVR before and after EVT was significantly greater in the Fontaine IV group than in the Fontaine IIa group (554.7±406.6 dynes·s·cm(−5) vs. 312.9±245.7 dynes·s·cm(−5), p=0.0151). The change in SVR was correlated with a change in mean BP in the upper limb (p=0.0026). When the change in pressure gradient between the upper limb and the diseased lower limb was large, mean BP of the upper limb significantly decreased (p=0.0022). Conclusion: EVT can reduce SVR and BP by canceling the pressure gradient between central BP and diseased lower-limb BP.