Abstract
SummaryBackgroundThe identification of patients at higher risk of developing percutaneous transluminal angioplasty (PTA)-related complications is pivotal for achieving better clinical outcomes. We carried out a single-center, observational, retrospective study to explore whether in-hospital changes of red blood cell distribution width (RDW) may help predicting early development of PTA-related complications.MethodsThe study population consisted of all consecutive patients who underwent PTA for severe peripheral artery occlusive disease (PAOD) during a 2-year period. RDW was measured at hospital admission and discharge, and the delta was calculated. Patient follow-up was routinely performed 1-month after hospital discharge, and was based on thoughtful medical assessment and arterial ultrasonography. The control population consisted of 352 ostensibly healthy subjects.ResultsThe final PTA group consisted of 224 patients. Hemoglobin was lower, whilst mean corpuscular volume (MCV) and RDW were higher in PAOD cases than in controls. Overall, 11 PAOD patients (4.9%) developed clinically significant PTA-related complications 1-month after hospital discharge. Patients who developed 1-month PTA-related complications had lower hemoglobin concentration, but higher RDW and delta RDW than those who did not. Patients with delta RDW >1 had 60% higher risk of developing 1-month PTA-related complications and 88% higher risk of developing early reocclusion. Overall, RDW exhibited an area under the curve (AUC) of 0.68 and 0.74 for predicting 1-month PTA-related complications and early reocclusion, respectively.ConclusionsThe results of this study suggest that RDW may play a role for guiding the clinical decision making of PTA patients immediately after hospital discharge.
Highlights
Peripheral artery occlusive disease (PAOD), known as peripheral artery disease (PAD), is a rather frequent pathology, affecting as many as 13% subjects aged 50 years or older in Western Countries [1]
The results of this study suggest that red blood cell distribution width (RDW) may play a role for guiding the clinical decision making of percutaneous transluminal angioplasty (PTA) patients immediately after hospital discharge
No PTA patients were lost on follow-up, but 18 of these patients ought to be excluded from our retrospective analysis since hematological testing was not performed at hospital discharge, so that the final PTA group consisted of 224 patients
Summary
Peripheral artery occlusive disease (PAOD), known as peripheral artery disease (PAD), is a rather frequent pathology, affecting as many as 13% subjects aged 50 years or older in Western Countries [1]. Albeit individuals with PAOD may remain asymptomatic for long, between 5–25% patients will manifest an array of worsening signs and symptoms (i.e., claudication, pallor, rest pain, paraesthesia, paralysis, up to ulceration and gangrene), which may require elective or urgent revascularization by endovascular or surgical techniques. In these patients, the 5-year risks of amputation and all-cause mortality are as high as 3% and 20%, respectively and, independently of the selected approach for revascularization, clinical results remain largely debated [2]. Albeit a number of complications, especially reocclusion, hematomas, arteriovenous fistulae, pseudoaneurysms and infections, may occur in more than half of patients within 1 year after PTA [4, 5], some patients may develop early acute complications and restenosis (i.e., within 1 to 3 months), which would require a timely, often urgent, endovascular management [6]
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