Abstract：
Cholesterol crystal embolism (CCE) accompanied by a lower extremity wound is occasionally difficult to differentiate from chronic limb-threatening ischemia (CLTI) and treat. The present multi-center retrospective observational study investigated the clinical characteristics and prognosis of CCE with lower extremity wounds. Consecutive patients (n = 58) clinically diagnosed as CCE with lower extremity wounds between April 2010 and December 2019 were studied. CCE was diagnosed using histological findings, foot condition, renal impairment, and eosinophilia. The primary outcome was 1-year wound healing rate. Patients with CCE were compared with 1309 patients diagnosed with CLTI with tissue loss during the same study period. The CCE group had a significantly more severe Wound, Ischemia, and foot Infection (WIfI) classification compared with the CLTI group. After Kaplan-Meier analysis, the CCE group had a similar 1-year wound healing (55.1 vs 58.3%, P = .096) as the CLTI group. In multivariate stratified Cox regression analysis by WIfI stages, CCE was significantly associated with poor wound healing compared with CLTI [hazard ratio .36 (95% confidence interval .21-.62)]. In conclusion, among the similar WIfI clinical stages, wound healing was significantly worse in the CCE group than in the CLTI group.
摘要：
伴有下肢伤口的胆固醇晶体栓塞（CCE）有时难以与慢性威胁肢体缺血（CLTI）区分和治疗。本多中心回顾性观察研究CCE伴下肢创伤的临床特点及预后。研究了2010年4月至2019年12月期间临床诊断为CCE的下肢伤口的连续患者（n=58）。CCE是用组织学检查结果诊断的，足部状况,肾功能损害，和嗜酸性粒细胞增多症.主要结果是1年伤口愈合率。在同一研究期间，将CCE患者与诊断为CLTI的1309名患者进行了比较。CCE组的伤口明显更严重，缺血，与CLTI组相比，足部感染（WIfI）分类。经过Kaplan-Meier分析,CCE组的1年伤口愈合相似（55.1vs58.3％，P=.096）作为CLTI组。在WIfI阶段的多变量分层Cox回归分析中，与CLTI相比，CCE与不良伤口愈合显着相关[风险比.36（95％置信区间.21-.62）]。总之,在相似的WIfI临床分期中，CCE组的伤口愈合明显比CLTI组差。
