Title Učestalost restenoza femoralne i poplitealne arterije kod bolesnika liječenih balonom obloženim lijekom u Kliničkom bolničkom centru Rijeka
Title (english) Incidence of femoral and popliteal artery restenosis in patients treated with drug coated balloons in Clinical Hospital Center Rijeka
Author Marko Zec
Mentor Boris Bezak (mentor)
Committee member Maja Karić (predsjednik povjerenstva)
Committee member Karlo Blažetić (član povjerenstva)
Committee member Boris Bezak (član povjerenstva)
Granter University of Rijeka Faculty of Health Studies (Department of Laboratory and Radiological Diagnostics) Rijeka
Defense date and country 2023-02-28, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Radiology
Abstract Periferna arterijska bolest (PAB) je vaskularno oboljenje koje rezultira suženjem ili okluzijom arterija što dovodi do smanjenja kvalitete života oboljelih, povećanog rizika od amputacija ekstremiteta ali i smrti, dok se broj oboljelih mjeri u milijunima. U slučaju sumnje na PAB, pacijenta se podvrgava kliničkom pregledu i objektivnim kliničkim testovima poput ispitivanja ABI indeksa (engl. ankle-brachial index) te laboratorijskim pretragama. U slučaju potvrđene kliničke sumnje, pristupa se slikovnoj dijagnostici kao što je angiografija kompjutoriziranom tomografijom (CTA), digitalna subtrakcijska angiografija (DSA) i angiografija magnetskom rezonancijom (MRA) kako bi se utvrdila lokacija i težina oboljenja. Nakon dijagnosticirane PAB, odluka o daljnjem liječenju se donosi na konziliju liječnika koji najčešće uključuje vaskularnog kirurga, intervencijskog radiologa i neurologa, a po potrebi i liječnike specijaliste iz drugih područja medicine. Cilj: Utvrditi učestalost restenoze femoralne i poplitealne arterije u razdoblju praćenja od godinu dana kod bolesnika liječenih u Kliničkom bolničkom centru Rijeka (KBC Rijeka) nakon liječenja balonima obloženim lijekom (DCB). Drugi cilj ovog rada je usporediti dobivene rezultate s rezultatima objavljenim u IN.PACT SFA multicentričnoj randomiziranoj studiji. Na taj način ćemo procijeniti uspješnost obavljenog postupka u KBC Rijeka u odnosu na rezultate drugih europskih i svjetskih centara. Materijali: Pretraživanjem baza podataka Kliničkog bolničkog centra Rijeka (ISSA i IBIS), retrospektivno su prikupljeni podaci o pacijentima kojima je obavljena perkutana transluminalna angioplastika (PTA) površinske femoralne i poplitealne arterije DCB metodom od 1. siječnja 2020. do 31. prosinca 2020. godine. Rezultati: U analizu je uključeno 79 bolesnika. Aritmetička sredina dobi bolesnika iznosi 68,32 godina (min 39, max 87, st.dev.8,8). Raspodjela bolesnika prema spolu je 20 pacijenata ženskog spola, odnosno 59 muškog. Pojavnost restenoze nakon provedenog liječenja je 20,25% (16 osoba), dok kod 79,75% (63 osobe) nije došlo do pojave restenoze u jednogodišnjem periodu praćenja. Zaključak: Rezultati provedenog istraživanja u KBC Rijeka pokazuju minimalno odstupanje od podataka objavljenih u IN.PACT SFA studiji u vidu učestalije pojavnosti restenoze kod pacijenata liječenih u našoj ustanovi u odnosu na IN.PACT SFA studiju (odstupanje za 2,45%). Činjenica da je naša studija provedena na manjem uzorku te da u obzir nisu uzete i druge podležeće bolesti kod bolesnika kao ni dužina i stupanj stenoze i/ili okluzije mogao bi biti razlog navedenim minimalnim odstupanjima između dvije studije. Zaključno možemo reći da su uočena odstupanja između dvije studije minimalna, no svakako je potrebna daljnja detaljnija analiza koja bi uključivala veći broj bolesnika te standardizaciju uključnih i isključnih kriterija kako bi mogli donijeti precizniji zaključak o uspješnosti metode.
Abstract (english) Peripheral arterial disease (PAD) is a vascular disease that results in the narrowing or blockage of arteries, which leads to a decrease in the quality of life of patients, an increased risk of limb amputations and death, while the number of patients is measured in millions. In case of suspicion of PAB, the patient undergoes a clinical examination and objective ABI index measurement (ankle-brachial index), as well laboratory tests. In case of confirmed clinical suspicion, imaging tests such as computed tomography angiography (CTA), digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) are used to determine the localization and severity of the disease. After PAB is diagnosed, the decision on further treatment is made at a doctor's council, which usually includes a vascular surgeon, an interventional radiologist and a neurologist, and if necessary, doctors specialized in other fields of medicine. Objective: To determine the frequency of femoral and popliteal artery restenosis over a period of one year in patients treated at the Clinical Hospital Center Rijeka (CHC Rijeka) after treatment with drug-coated balloons (DCB). Another goal of this paper is to compare the obtained results with the results published in the IN.PACT SFA multicenter randomized study. In this way, we will evaluate the success of the procedure performed at CHC Rijeka in relation to the results of other European and international centers. Materials: By searching the databases of the Rijeka Clinical Hospital Center (ISSA and IBIS – integrated hospital information system), data were collected retrospectively on patients who underwent percutaneous transluminal angioplasty (PTA) of the superficial femoral and popliteal arteries using the DCB method from January 1st, 2020 to December 31st of 2020. Results: 79 patients were included in the analysis. The arithmetic mean of the patient's age is 68.32 years (min 39, max 87, st.dev.8.8). The distribution of patients by gender is 20 female patients and 59 male patients. The occurrence of restenosis after treatment was 20.25% (16 people), while 79.75% (63 people) did not experience restenosis in the one-year follow-up period. Conclusion: Results of the research performed at CHC Rijeka show a minimal deviation from the data published in the IN.PACT SFA study in the form of a more frequent occurrence of restenosis in patients treated in our institution compared to the patients included in IN.PACT SFA study (a deviation of 2.45%). The fact that our study was conducted on a smaller sample and that other underlying diseases of the patients as well as the length and degree of stenosis or occlusion were not considered, could be the reason for the earlier mentioned minimal deviations between the two studies. In conclusion, we can say that the observed deviations between the two studies are minimal, but a further, more detailed analysis that would include a larger number of patients and the standardization of inclusion and exclusion criteria is necessary in order to make a more precise conclusion about the success of the method.
Keywords
periferna arterijska bolest
restenoza
femoralna arterija
poplitealna arterija
balon obložen lijekom
Keywords (english)
peripheral arterial disease
restenosis
femoral artery
popliteal artery
drug-coated balloon
Language croatian
URN:NBN urn:nbn:hr:184:237706
Study programme Title: Radiological Technology Study programme type: professional Study level: undergraduate Academic / professional title: stručni/a prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije (stručni/a prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije)
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File origin Born digital
Access conditions Open access Embargo expiration date: 2023-03-07
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Created on 2023-02-18 14:40:48