Bleeding events and mid-term mortality in the patients undergoing endovascular interventions for peripheral artery disease of the lower limbs based on the academic research consortium high bleeding risk criteria

• Published in: Heart and vessels Vol. 36; no. 9; pp. 1336 - 1349
• Main Authors: Yoshioka, Naoki, Takagi, Kensuke, Morita, Yasuhiro, Kanzaki, Yasunori, Nagai, Hiroaki, Watanabe, Naoki, Morishima, Itsuro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2021; Springer Nature B.V
• Subjects: Adverse events; Biomedical Engineering and Bioengineering; Bleeding; Cardiac Surgery; Cardiology; Cardiovascular system; Consortia; Criteria; Hemorrhage - etiology; Humans; Lower Extremity; Medicine; Medicine & Public Health; Mortality; Original Article; Patients; Percutaneous Coronary Intervention; Peripheral Arterial Disease - diagnosis; Peripheral Arterial Disease - surgery; Platelet Aggregation Inhibitors; Retrospective Studies; Risk Assessment; Risk Factors; Treatment Outcome; Vascular diseases; Vascular Surgery; Peripheral artery disease; Endovascular therapy; Mortality; Bleeding events; High bleeding risk
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-021-01804-3

This study applied the Academic Research Consortium for HBR (ARC-HBR) criteria to peripheral artery disease (PAD) patients after Endovascular therapy (EVT) and assessed the prevalence of HBR, as well as the association between HBR and clinical outcomes. This is a single-center, non-randomized, controlled, and retrospective study. EVTs for symptomatic PAD are minimally invasive and efficient. Although bleeding can be a serious adverse event, the criteria for HBR and assessment of bleeding events in patients who underwent EVT have been limited. A total of 156 patients with PAD who underwent EVT were divided into two groups according to ARC-HBR criteria. The associations between HBR and bleeding events, which was defined as Bleeding Academic Research Consortium Type 3 or Type 5 bleeding within 1 year and all-cause mortality within 1 year, were analyzed. The percentage of patients who were categorized as having HBR was 75.0%. Bleeding events occurred in 12.6% of the patients. All bleeding events occurred in the HBR group, while no bleeding events occurred in the no-HBR group. (16.9% vs. 0.0%, respectively; p  = 0.008). During the follow-up period, 11.1% of the patients had died. All-cause mortality was significantly higher in the HBR group than in the no-HBR group (14.7% vs. 0.0%, respectively; p  = 0.019). Most patients with PAD were classified as having HBR as assessed by ARC-HBR criteria, and patients with HBR were at a higher risk of not only bleeding events but also mid-term mortality compared to those without HBR. ARC-HBR criteria can be a helpful parameter when treating PAD patients after EVT.