Efficacy of endoluminal interventional therapy in diabetic peripheral arterial occlusive disease: a retrospective trial

Abstract

BackgroundThe purpose of this study was to assess the efficacy of interventional therapy for peripheral arterial occlusive disease and the difference between diabetic patients and non-diabetic patients.Methods139 consecutive patients between September 2006 and September 2010 who underwent percutaneous lower extremity revascularization for arterial lesions were divided into diabetes group (n = 62) and non-diabetes group (n = 77). Before intervention, rest ankle brachial indexes and three dimensional computed tomography angiography from abdominal aorta to tiptoe were performed. The interventional treatments included angioplasty with or without stenting. The clinical outcomes included rest ankle-brachial indexes, primary patency rates, secondary patency rates and limb-salvage rates for 6-month, 12-month, 24-month and 36-month after treatment. The primary and secondary patency rates of all interventions and the limb-salvage rates of the patients are illustrated by Kaplan-Meier curves and compared by log-rank analysis.ResultsThe interventional operation success rates were 98.4% (61/62) in diabetes group and 100% (77/77) in non-diabetes group. The re-interventional operation success rates were 85.7% (18/21) in diabetes group and 76.9% (20/26) in non-diabetes group. The mean value of ankle brachial indexes was significantly increased after intervention (0.397 ± 0.125 versus 0.779 ± 0.137, t = -25.780, P < 0.001) in diabetes group and (0.406 ± 0.101 versus 0.786 ± 0.121, t = -37.221, P < 0.001) in non-diabetes group. Perioperative 30-day mortality was 0%. Major complications included groin hematoma in 7.2%, and pseudoaneurysm formation 2.2%. In diabetes group, 6, 12, 24, and 36-month primary patency rates were 88.7% ± 4.0%, 62.3% ± 6.6%, 55.3% ± 7.0%, and 46.5% ± 7.5%; secondary patency rates were 93.5% ± 3.1%, 82.3% ± 5.1%, 70.8% ± 6.5%, and 65.7% ± 7%; limb-salvage rates were 95.2% ± 2.7%, 87.7% ± 4.4%, 85.5% ± 4.8%, and 81.9% ± 5.8%. In non-diabetes group, 6, 12, 24, and 36-month primary patency rates were 90.9% ± 3.3%, 71.8% ± 5.4%, 71.8% ± 5.4%, and 60.9% ± 6.2%; secondary patency rates were 96.1% ± 2.2%, 91.6% ± 3.3%, 82.7% ± 4.8%, and 71.8% ± 6.2%; limb-salvage rates were 97.4% ± 1.8%, 94.4% ± 2.7%, 90.6% ± 3.7%, and 83.1% ± 5.4%. The differences between two groups were not significant (P > 0.05).ConclusionWith a low risk of morbidity and mortality, the percutaneous revascularization accepted by patients does not affect ultimate necessary surgical revascularization and consequently should be considered as the preferred therapy for chronic lower extremity ischemia. The efficacy and prognosis of interventional therapy in diabetic patients is similar that in non-diabetic patients.

Influence of fibrinogen and C-RP on progression of peripheral arterial disease in type 2 diabetes: a preliminary report

“…ABI is defined as reliable marker for definition PAD, despite numerous factors that influence its value [39]. We measured progression of peripheral atherosclerosis using this index.…”

Efficacy of endoluminal interventional therapy in diabetic peripheral arterial occlusive disease: a retrospective trial

“…Lejay et al [32] reported at 1 year the infra-popliteal arteries primary patency rates and limb salvage rates for PTA were 60% and 85%, respectively. In a contrast study between PTA and atherectomy of infra-popliteal arterial occlusive disease, Semaan et al [33] reported primary patency of the popliteal artery at 12 months were 75% and 73%, respectively, but the difference was not statistically significant. In our study, 6, 12 months primary patency rate for tibial arterial lesions with or without diabetes were 75%, 53.8% and 73.7%, 55.3%.…”

Khảo Sát Mật Độ Xương Và Một Số Yếu Tố Liên Quan Ở Bệnh Nhân Bệnh Phổi Tắc Nghẽn Mạn Tính Điều Trị Ngoại Trú Tại Bệnh Viện Bạch Mai

“…Bảng 3: Thái độ của học sinh về hút thuốc lá (n=3873) Hút shishsa có hại cho sức khoẻ của bạn 155(4,0) 62 (1,6) 397 (10,3) 3242(83,7) 17(0,4) Hút thuốc lá điện tử có hại cho sức khoẻ của bạn 149 (3,9) 103(2,7) 399 (10,3) 3207(82,8) 15(0,4)…”

“…Nghiên cứu của Nguyễn Xuân Thanh (2015) bệnh nhân nữ là 56,8%, nam là 43,2%. 10 Sự khác biệt của các nhà nghiên cứu cũng không có ý nghĩa thống kê.…”