Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization
Percutaneous deep venous arterialization (pDVA) is a promising treatment option in patients with chronic limb-threatening ischemia. Stenosis and occlusions, which are the Achilles’ heel of every revascularization procedure, can be treated when detected early. However, frequent monitoring after pDVA...
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| Format: | Article |
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MDPI AG
2021-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/6/1008 |
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| author | Eline Huizing Michiel A. Schreve Steven Kum Grigorios Papageorgiou Jean-Paul P. M. de Vries Gert J. de Borst Çağdaş Ünlü |
| author_facet | Eline Huizing Michiel A. Schreve Steven Kum Grigorios Papageorgiou Jean-Paul P. M. de Vries Gert J. de Borst Çağdaş Ünlü |
| author_sort | Eline Huizing |
| collection | DOAJ |
| description | Percutaneous deep venous arterialization (pDVA) is a promising treatment option in patients with chronic limb-threatening ischemia. Stenosis and occlusions, which are the Achilles’ heel of every revascularization procedure, can be treated when detected early. However, frequent monitoring after pDVA is required because when stenosis or occlusions develop is unknown. Therefore, patients currently need to visit the hospital every 2 weeks for surveillance, which can be burdensome. Accordingly, we aimed to develop a model that can predict future stenosis or occlusions in patients after pDVA to be able to create tailor-made follow-up protocols. The data set included 343 peak systolic velocity and 335 volume flow measurements of 23 patients. A stenosis or occlusion developed in 17 patients, and 6 patients remained lesion-free. A statistically significant increase in the risk of stenosis or occlusion was found when duplex ultrasound values decreased 20% within 1 month. The prediction model was also able to estimate a patient-specific risk of future stenosis or occlusions. This is promising for the possibility of reducing the frequency of follow-up visits for low-risk patients and increasing the frequency for high-risk patients. These observations are the starting point for individual surveillance programs in post-pDVA patients. Future studies with a larger cohort are necessary for validation of this model. |
| first_indexed | 2024-03-10T10:49:32Z |
| format | Article |
| id | doaj.art-2801335addeb4c75baf45d413a7ec685 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T10:49:32Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-2801335addeb4c75baf45d413a7ec6852023-11-21T22:18:47ZengMDPI AGDiagnostics2075-44182021-05-01116100810.3390/diagnostics11061008Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous ArterializationEline Huizing0Michiel A. Schreve1Steven Kum2Grigorios Papageorgiou3Jean-Paul P. M. de Vries4Gert J. de Borst5Çağdaş Ünlü6Department of Surgery, Northwest Clinics, 1815 JD Alkmaar, The NetherlandsDepartment of Surgery, Northwest Clinics, 1815 JD Alkmaar, The NetherlandsVascular Service, Department of Surgery, Changi General Hospital, Singapore 529889, SingaporeDepartment of Biostatistics, Erasmus University Medical Centre, 3015 GD Rotterdam, The NetherlandsDepartment of Surgery, Division of Vascular Surgery, University Medical Centre Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Vascular Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The NetherlandsDepartment of Surgery, Northwest Clinics, 1815 JD Alkmaar, The NetherlandsPercutaneous deep venous arterialization (pDVA) is a promising treatment option in patients with chronic limb-threatening ischemia. Stenosis and occlusions, which are the Achilles’ heel of every revascularization procedure, can be treated when detected early. However, frequent monitoring after pDVA is required because when stenosis or occlusions develop is unknown. Therefore, patients currently need to visit the hospital every 2 weeks for surveillance, which can be burdensome. Accordingly, we aimed to develop a model that can predict future stenosis or occlusions in patients after pDVA to be able to create tailor-made follow-up protocols. The data set included 343 peak systolic velocity and 335 volume flow measurements of 23 patients. A stenosis or occlusion developed in 17 patients, and 6 patients remained lesion-free. A statistically significant increase in the risk of stenosis or occlusion was found when duplex ultrasound values decreased 20% within 1 month. The prediction model was also able to estimate a patient-specific risk of future stenosis or occlusions. This is promising for the possibility of reducing the frequency of follow-up visits for low-risk patients and increasing the frequency for high-risk patients. These observations are the starting point for individual surveillance programs in post-pDVA patients. Future studies with a larger cohort are necessary for validation of this model.https://www.mdpi.com/2075-4418/11/6/1008venous arterializationchronic limb threatening ischemiaduplexrestenosisocclusionreintervention |
| spellingShingle | Eline Huizing Michiel A. Schreve Steven Kum Grigorios Papageorgiou Jean-Paul P. M. de Vries Gert J. de Borst Çağdaş Ünlü Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization Diagnostics venous arterialization chronic limb threatening ischemia duplex restenosis occlusion reintervention |
| title | Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization |
| title_full | Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization |
| title_fullStr | Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization |
| title_full_unstemmed | Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization |
| title_short | Development of a Prediction Model for the Occurrence of Stenosis or Occlusion after Percutaneous Deep Venous Arterialization |
| title_sort | development of a prediction model for the occurrence of stenosis or occlusion after percutaneous deep venous arterialization |
| topic | venous arterialization chronic limb threatening ischemia duplex restenosis occlusion reintervention |
| url | https://www.mdpi.com/2075-4418/11/6/1008 |
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