Impact of Chronic Kidney Disease on the Effectiveness of Peripheral Endovascular Interventions

Abstract

success rate was 98.3%. The median follow-up duration was 51 months. Overall, limb loss at 2 years was 8.9% (n 1⁄4 10), but 10.2% in patients who had smoked (9 of 88) vs 4.2% in those who had not (1 of 24). Compared with the latter, risk-adjusted odds ratios were 3.3 (P 1⁄4 .04), 2.8 (P 1⁄4 .05), and 1.6 (P 1⁄4 .1) for those whose timing of smoking cessation was categorized as current smoker, quit just after intervention, and quit 3 months preoperatively. Occurrence of reintervention at 2 years was 22.3% (n 1⁄4 25) overall, but 25% in patients who had smoked (22 of 88) vs 12.5% in those who had not (3 of 24). Compared with the latter, risk-adjusted odds ratios were 4.3 (P 1⁄4 .01), 2.3 (P 1⁄4 .03), and 1.2 (P 1⁄4 .1) for those whose timing of smoking cessation was categorized as above. Conclusions: Direct effects of smoking on peripheral arterial reactivity are considered to be responsible for premature failure after intraluminal treatment of CLI in young patients. Smoking cessation is presumed to be beneficial before endovascular treatment. Risks of limb loss and reintervention after intervention are increased by smoking and mitigated gradually by preoperative cessation.