The relationship between lower extremity arterial calcification and hemodynamics and the effect of peripheral vascular stent combined with batroxobin in patients with lower extremity arteriosclerosis obliterans

Zhao Feng; Deng Mo

doi:10.3760/j.issn.1673-4777.2024.10.015

Abstract：Objective To investigate the relationship between lower extremity arterial calcification and hemodynamics and the effect of peripheral vascular stent combined with batroxobin in patients with lower extremity arteriosclerosis obliterans(ASO).Methods A total of 120 patients with ASO who received peripheral vascular stent combined with batroxobin in the Affiliated Hospital of Hebei University from February 2022 to February 2024 were selected as the observation group,and 60 patients with ankle brachial index ≥0.9 were selected as the control group(non-ASO patients).The patients were divided into the good prognosis group(62 cases,the degree of restenosis ≤50％)and the poor prognosis group(58 cases,the degree of restenosis＞50％)according to whether the restenosis was＞50％at 6 months after treatment.The clinical data of the observation group and the control group were compared,and the hierarchical regression analysis was used to analyze the relationship between hemodynamic parameters and superficial femoral artery calcification score(SFACS)and inferior genicular artery calcification score(BKACS).The clinical data,ankle-brachial index(ABI)and toe-brachial index(TBI)before and after treatment were compared between the good prognosis group and the poor prognosis group.Cox regression analysis was used to evaluate the relationship between SFACS,BKACS and poor prognosis of patients.Multiple linear regression analysis was used to analyze the relationship between SFACS,BKACS and ABI,TBI.Restricted cubic spline model was used to analyze the dose-effect relationship between SFACS,BKACS and the risk of poor prognosis in ASO patients.Results The age,proportion of males,proportion of smoking history,peak systolic blood flow velocity(Vs)of posterior tibial artery,Vs of dorsalis pedis artery,SFACS and BKACS of the observa-tion group were significantly higher than those of the control group,and the diameter of posterior tibial artery and dorsalis pedis artery were significantly lower than those of the control group(all P＜0.05).The internal diameter of posterior tibial artery and dorsalis pedis artery had a significant negative effect on SFACS and BKACS,and the posterior tibial artery Vs and dorsalis pedis artery Vs had a significant positive effect on SFACS and BKACS(all P＜0.05).There were significant differences in C-reactive protein,albumin,fibrinogen,SFACS[2 282(856,3 259)vs 4 236(1 547,6 325)]and BKACS[1 024(526,1 730)vs 1 951(1 157,2 968)]between the good prognosis group and the poor prognosis group(all P＜0.05).The ABI and TBI of the good prognosis group were significantly higher than those of the poor prognosis group at 6 months,1 year and 2 years after treatment(all P＜0.05).Before and after adjusting for confounding factors,SFACS and BKACS were positively correlated with the risk of poor prognosis,and were negatively correlated with ABI and TBI(all P＜0.05).The risk of poor prognosis in ASO patients increased with the increase of SFACS and BKACS(non-linear P=0.762,0.395).Conclusion The level of lower extremity arterial calcification is related to the hemodynamics of patients with ASO,and it can evaluate the therapeutic effect of peripheral vascular stent combined with batroxobin to a certain extent.Therefore,in the treatment of ASO,it can be used as one of the examination marks for clinical treatment to optimize the treatment plan in time.