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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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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
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author Nomoto, Hidetsugu
Nozato, Toshihiro
Yamashita, Shu
Suzuki, Masahito
Sugiyama, Tomoyo
Oumi, Tetsuo
Ohno, Masakazu
Shimizu, Shigeo
Ashikaga, Takashi
Satoh, Yasuhiro
author_facet Nomoto, Hidetsugu
Nozato, Toshihiro
Yamashita, Shu
Suzuki, Masahito
Sugiyama, Tomoyo
Oumi, Tetsuo
Ohno, Masakazu
Shimizu, Shigeo
Ashikaga, Takashi
Satoh, Yasuhiro
author_sort Nomoto, Hidetsugu
collection PubMed
description 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.
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spelling pubmed-77585932020-12-31 Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease Nomoto, Hidetsugu Nozato, Toshihiro Yamashita, Shu Suzuki, Masahito Sugiyama, Tomoyo Oumi, Tetsuo Ohno, Masakazu Shimizu, Shigeo Ashikaga, Takashi Satoh, Yasuhiro Ann Vasc Dis Original Article 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. Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2020-12-25 /pmc/articles/PMC7758593/ /pubmed/33391554 http://dx.doi.org/10.3400/avd.oa.20-00086 Text en © 2020 The Editorial Committee of Annals of Vascular Diseases. http://creativecommons.org/licenses/by/2.5/ This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.
spellingShingle Original Article
Nomoto, Hidetsugu
Nozato, Toshihiro
Yamashita, Shu
Suzuki, Masahito
Sugiyama, Tomoyo
Oumi, Tetsuo
Ohno, Masakazu
Shimizu, Shigeo
Ashikaga, Takashi
Satoh, Yasuhiro
Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease
title Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease
title_full Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease
title_fullStr Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease
title_full_unstemmed Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease
title_short Effect of Endovascular Treatment on Systemic Vascular Resistance in Patients with Lower-Limb Peripheral Artery Disease
title_sort effect of endovascular treatment on systemic vascular resistance in patients with lower-limb peripheral artery disease
topic Original Article
url 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
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