PDF(Pubmed)
Abstract：
BACKGROUND: The primary approach for treating ischemic wounds is restoring oxygen supply to the ischemic region. While direct angiosomal revascularization is often associated with better post-operative wound healing and limb salvage, its superiority over non-angiosomal revascularization remains controversial. This study aimed to compare intraoperative tissue oxygen saturation changes in ischemic zones following either direct or indirect revascularization in below-the-knee arteries.
METHODS: This prospective observational study included patients undergoing direct and indirect below-the-knee endovascular revascularizations. Assignment to the groups was not randomized. Near-infrared spectroscopy was used to monitor rSO2 changes near the ischemic wounds intraoperatively. The changes were compared between the groups.
RESULTS: 15 patients (50%) underwent direct angiosomal revascularization, while an equal number of patients underwent indirect revascularization. Overall, a statistically significant increase in regional oxygen saturation was observed after revascularization (p = 0.001). No statistically significant difference was found between the direct and indirect revascularization groups (p = 0.619).
CONCLUSIONS: This study revealed a minor difference in the oxygen saturation increase between the angiosomal and non-angiosomal revascularization groups. Such a finding indicates that the clinical significance of angiosomal revascularization is negligible and might be concealed by confounding factors, such as the vessel diameter and outflow impact on the restenosis rate.
METHODS: This prospective observational study included patients undergoing direct and indirect below-the-knee endovascular revascularizations. Assignment to the groups was not randomized. Near-infrared spectroscopy was used to monitor rSO2 changes near the ischemic wounds intraoperatively. The changes were compared between the groups.
RESULTS: 15 patients (50%) underwent direct angiosomal revascularization, while an equal number of patients underwent indirect revascularization. Overall, a statistically significant increase in regional oxygen saturation was observed after revascularization (p = 0.001). No statistically significant difference was found between the direct and indirect revascularization groups (p = 0.619).
CONCLUSIONS: This study revealed a minor difference in the oxygen saturation increase between the angiosomal and non-angiosomal revascularization groups. Such a finding indicates that the clinical significance of angiosomal revascularization is negligible and might be concealed by confounding factors, such as the vessel diameter and outflow impact on the restenosis rate.
摘要：
背景:治疗缺血性伤口的主要方法是恢复对缺血区域的氧供应。虽然直接血管小体血运重建通常与更好的术后伤口愈合和肢体抢救有关，其优于非血管小体血运重建的优势仍存在争议.这项研究旨在比较膝关节下动脉直接或间接血运重建后缺血区的术中组织氧饱和度变化。
方法：这项前瞻性观察性研究包括接受直接和间接膝下血管内血管重建的患者。对这些组的分配不是随机的。近红外光谱法用于在术中监测缺血伤口附近的rSO2变化。比较各组之间的变化。
结果：15例患者（50%）接受了直接血管小体血运重建，而同样数量的患者接受了间接血运重建。总的来说,血运重建后观察到区域血氧饱和度显著增加(p=0.001).直接和间接血运重建组之间无统计学差异（p=0.619）。
结论：这项研究显示，血管小体和非血管小体血运重建组之间的氧饱和度增加有微小差异。这一发现表明，血管血运重建的临床意义可以忽略不计，并且可能被混杂因素掩盖。如血管直径和流出对再狭窄率的影响。
方法：这项前瞻性观察性研究包括接受直接和间接膝下血管内血管重建的患者。对这些组的分配不是随机的。近红外光谱法用于在术中监测缺血伤口附近的rSO2变化。比较各组之间的变化。
结果：15例患者（50%）接受了直接血管小体血运重建，而同样数量的患者接受了间接血运重建。总的来说,血运重建后观察到区域血氧饱和度显著增加(p=0.001).直接和间接血运重建组之间无统计学差异（p=0.619）。
结论：这项研究显示，血管小体和非血管小体血运重建组之间的氧饱和度增加有微小差异。这一发现表明，血管血运重建的临床意义可以忽略不计，并且可能被混杂因素掩盖。如血管直径和流出对再狭窄率的影响。
