| Objective: Superficial femoral artery(SFA)occlusion disease is one of the common peripheral artery diseases(PAD).Due to the increased morbidity and mortality of PAD,patients with SFA occlusion disease are also increasing yearly.Endovascular treatment,compared with exercise treatment,medication treatment,percutaneous transluminal angioplasty,is the primary treatment in the clinical area,because of its simple operation,mini-wound,and lower requirements of the surgical condition.However,even it was treated as the preferred treatment,like other treatments,patients may experience occlusion again after treatment,which will reduce the quality of life or survival time.In addition,the cost of endovascular treatment and the cost of subsequent related medical treatment are also relatively high.Therefore,if the surgeon can estimate the patency rate after endovascular treatment of such patients before surgery,they can decide from endovascular treatment or other conservative treatments according to the predicted results.Bad results will be purposefully avoided.A comprehensive and easily accessible clinical risk prediction tool plays an important role in identifying high-risk cases of SFA occlusion patients,which will also optimize the medical expense.Methods: In the statistical description,T-test and rank-sum test were used to describe the variables that conform to the normality and do not.The results were expressed as mean standard deviation,and the categorical variables are expressed as the median(minimum-maximum Express).In this study,the construction of the short-term risk scoring system for endovascular treatment outcomes in SFA occlusion patients was consistent with the construction of the long-term risk scoring system.Effect factors were screened by Logistic regression analysis,which was used as independent variables.Subsequently,choosing the patency of one month and twelve months were treated as a dependent variable,and the Logistic stepwise regression was used to screen the factors,respectively.Then,to obtain reasonable risk factors,10-fold cross-validation and Logistic stepwise regression were used to fit the model.A risk score of one month or twelve months were calculated by using the risk score criteria and the results of each patient's index,respectively.A hazard scoring system was constructed based on the regression coefficients ? and OR values.Finally,according to the ROC curve and the area under the curve,the risk scoring system was evaluated that dividing into high risk and low risk with cutoff points with different risk scores.Results: 1.A total of 383 patients met the enrollment criteria.The minimum age was 43.1 years,the maximum age was 94.9 years,and the average age was 72.2 years.Additionally,256 of them were male patients,127 of them were female patients,male patients' age was 70.7 and female was 75.3.Besides,the number of smoking patients were 210(54.8%),with an average BMI of 23.5.2.All patients' average distance of claudication was 136.4 meters,the ankle index(ABI)was 0.37,and the average embolization stenosis was 82.2% before the endovascular treatment.3.The average age of patients who were followed up for one-month was 72.4 years old,with 211 male patients,109 female patients,and 53.4% smoking patients.80.4%(259)patients' superficial femoral artery(SFA)remained unobstructed after endovascular treatment with 823.2 m average claudication distance and 0.79 mean ABI.4.Follow-up at 12 months,the average age was 72.1 years,139 of them were men and 74 of them were women with 48.4% of smokers.The patency rate of SFA was 47.9%(103 patients),the average claudication distance was 460.6 m,and the average ABI was 0.67 at that time.5.The factors of short-term outcomes in patients with SFA occlusion disease including ABI,the history of diabetes and triglycerides.Similarly,factors of long-term outcomes including the history of diabetes,triglycerides,fasting blood-glucose,embolism degree,and smoking.6.The short-term outcome risk score formula for endovascular treatment of patients with SFA occlusion disease is: risk score = 6 × ABI + 1 × diabetes history + 3 × triglycerides and the long-term outcome risk score formula is: risk score = 2 × history of diabetes + 5 × triglycerides +8 × fasting blood glucose + 2 × embolism + smoking.Conclusion: 1.ABI,the history of diabetes and triglycerides affect SFA occlusion patients' endovascular treatment results in short-term and embolism,history of diabetes,triglycerides,fasting blood glucose,smoking effect that in long-term.2.The short-term outcome risk score for patients with SFA occlusion is 6 × ABI + 1 × diabetes history + 3 × triglycerides and the long-term outcome risk score is 2 × diabetes history + 5 × triglyceride+8 × fasting blood glucose + 2 × embolization + smoking.3.These two predictor models both have great predictive ability,which can be used as auxiliary indicators before endovascular treatment for SFA occlusion patients. |
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