Takagi G, Kirinoki-Ichikawa S, Tara S, Takagi I, Miyamoto M, et al.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi. Date of publication 2024 Mar 9;volume 91(1):66-73.
1. J Nippon Med Sch. 2024 Mar 9;91(1):66-73. doi: 10.1272/jnms.JNMS.2024_91-106.
Epub 2023 Dec 8.
Effectiveness of Repetitive Hyperbaric Oxygen Therapy for Chronic
Limb-Threatening Ischemia.
Takagi G(1), Kirinoki-Ichikawa S(1), Tara S(1), Takagi I(1), Miyamoto M(1).
Author information:
(1)Department of Cardiovascular Medicine, Nippon Medical School.
BACKGROUND: Lower extremity artery disease is strongly associated with morbidity
and is typically addressed through revascularization interventions. We assessed
the clinical outcomes of patients with chronic limb-threatening ischemia (CLTI)
without revascularization who did and did not undergo repetitive hyperbaric
oxygen therapy (HBOT).
METHODS: Between April 2002 and March 2017, the records of 58 patients with CLTI
(Rutherford classification 4 in 19% and 5 in 81%) were evaluated
retrospectively. HBOT was performed at 2.8 atm of oxygen (HBOT group). The
control group included those who could not continue HBOT and historical
controls. Patients in poor general health or with an indication for
revascularization therapy were excluded. We examined major adverse events (MAEs)
and limb salvage rates. Independent predictors and risk stratification were
analyzed using a multivariate regression analysis.
RESULTS: The mean age was 71±13 years. Of all patients, 67% had diabetes and 43%
were undergoing hemodialysis. The mean follow-up period was 4.3±0.8 years. The
overall survival rate was 84.5% and 81.0% at 1 and 3 years, respectively. The
Cox regression analysis indicated that high body mass index (odds ratio [OR]:
0.86; 95% confidence interval [CI]: 0.76-0.97; p=0.01), well-nourished (OR:
1.21; 95% CI: 1.01-1.45), and HBOT (OR: 0.05; 95% CI: 0.01-0.26; p<0.001)
independently predicted absence of MAEs. For major limb amputation, the
ankle-brachial index (OR: 0.2; 95% CI: 0.05-0.86; p=0.03) and HBOT (OR: 0.04;
95% CI: 0.004-0.32; p=0.003) were independent predictors.
CONCLUSIONS: Repetitive, stand-alone HBOT was associated with MAE-free survival
and limb salvage in patients with CLTI.
DOI: 10.1272/jnms.JNMS.2024_91-106
PMID: 38072421 [Indexed for MEDLINE]
