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말초동맥질환의 혈관재개통후 재협착과 술전 혈중 호모시스테인 농도의 연관성

Title
말초동맥질환의 혈관재개통후 재협착과 술전 혈중 호모시스테인 농도의 연관성
Other Titles
The Effects of the Preoperative Serum Homocysteine Level on Restenosis after Infraninguinal Bypass Surgery or Endovascular Surgery for Peripheral Arterial Disease
Author
권오정
Keywords
Peripheral arterial disease; Restenosis; Hyperhomocysteinemia; 말초동맥질환; 재협착; 고호모시스테인혈증
Issue Date
2011-01
Publisher
대한혈관외과학회
Citation
대한혈관외과학회지, 2011, 27(1), P.14-18
Abstract
Purpose: Hyperhomocysteinemia is accepted as an independent risk factor for peripheral arterial disease (PAD). The purpose of this study is to evaluate the correlation between the preoperative plasma homocysteine concentration and restenosis after therapeutic revascularization.Methods: We retrospectively analyzed the clinical records of 58 consecutive patients (they were confined to Trans Atlantic Inter-Society Consensus [TASC] type C & D) among 103 patients who were diagnosed as having infrainguinal PAD and who were treated with bypass surgery or endovascular surgery from July 2003to July 2009. We analyzed the effect of several factors such as gender, age, the plasma lipid profile and the protein C, protein S, fibrinogen, C-reactive protein, diabetes mellitus, hypertension, ankle-brachial index (ABI),and homocysteine levels, which are all considered to be risk factors for restenosis. Multivariate and univariate analyses were performed to assess the effect of possible confounders.Results: The subjects were 50 men and 8 women (mean age: 63.8±10.9). There were 33 (56.9%) cases of bypass surgery and 25 (43.1%) cases of endovascular surgery. Of them, 19 cases (32.8%) showed restenosis after revascularization. In the patients with restenosis, 18 cases (94.7%) showed a preoperative high plasma homocysteine level and 1 case (5.2%) showed a normal level. A lower ABI and hyperhomocysteinemia were significantly more common in the patients with restenosis (P=0.025, P<0.001). There were no significant differences of the other factors, except for the plasma homocysteine level on multivariate analysis (P=0.001).Conclusion: We can regard the preoperative hyperhomocysteinemia level as a predictive marker of restenosis after revascularization. Special attention may need to be given to the patients who have a lower preoperative ABI and hyperhomocysteinemia after revascularization.
URI
http://www.vsijournal.org/journal/view.html?uid=61&sort=&scale=&key=year&keyword=&s_v=27&s_n=1&pn=vol&year=2011&vmd=Full
ISSN
2288-7970
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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