Graft patency and clinical outcome of femorodistal arterial reconstruction in diabetic and non-diabetic patients: Results of a multicentre comparative analysis

Wölfle, K. D.; Bruijnen, H.; Loeprecht, H.; Rümenapf, G.; Schweiger, H.; Grabitz, K.; Sandmann, W.; Lauterjung, L.; Largiadèr, J; Erasmi, H; Kasprzak, Piotr; Raithel, D; Allenberg, Jens-Rainer; Lauber, Andrea H.; Berlakovich, G.M.; Kretschmer, G.; Hepp, W.; Becker, H. M.; Schulz, Andreas

doi:10.1053/ejvs.2002.1849

Cited by 93 publications

(79 citation statements)

References 17 publications

(8 reference statements)

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“…Considered together,these may suggest poorer outcome in treated patients or,even worse, may completely discourage any aggressive vascular surgical treatment in these patients (22). however, despite decreased surdespite decreased survival among diabetics (19,23,24) therei se vidence that bypass grafting to the leg is worthwhile (19)(20)(21)(22)(23)(24). In anation-wide analysis of diabetes as arisk factor for postoperative major mortality and morbidity after surgery for CLI in Finland during 1991-1999, diabetes was found to be an independent risk factor for postoperative BK amputation (37).…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have shown an inverse correlation between the incidence of infrainguinal bypass reconstruction and that of amputation (5, [14][15][16][17][18]. Equal patency and limb salvage rates after infrainguinal revascularization for diabetic and nondiabetic patients have been reported (19)(20)(21)(22)(23)(24). Furthermore, implementation of am ultidisciplinary team implementationo fam ultidisciplinary team approach for prevention and treatment of diabetic foot ulcers has reported to be effective means of preventing amputations (25)(26)(27)(28)(29)(30)(31).…”

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confidence: 99%

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Major Amputation Incidence Decreases Both in Non-Diabetic and in Diabetic Patients in Helsinki

Eskelinen

Albäck

et al. 2006

Scand J Surg

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Background andAims: The aim of the study was to assess the changes in diabetes-related lower extremity amputationsand to compare it with the development of amputations for criticalleg ischaemia in patients without diabetes.Material and Methods: Clinical records of 1094 patients undergoing major lower limb amputations for vascular disease in the town of Helsinki during 13 years from 1990 to 2002 were analyzed retrospectively. Data concerning patientfactors,diagnosis,existence of diabetes and amputation level were recorded. The studyperiod was divided into three parts (1990-1994, 1995-1998 and 1999-2002) and results were compared between diabetic and nondiabetic vascular amputees during these time periods.Results: From 1990 through 2002, 561 of patients undergoing major lower limb amputation had diabetes mellitus. The overall incidenceo fm ajor amputations of diabetics reduced from the first time period to the last period by 23%. At the same time, the incidence of amputations in non-diabetic patient group decreased 40%. If the incidence rate fora mputations is expressed per million individuals with diabetes, 33% decrease was observedduring the study period.Conclusions: The decrease in majora mputation rates among diabetic as well as nondiabetic patients can be attributed to the increasedi nterest in amputation prevention, with acontribution by vascular surgeonsbeing made in both groups.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Major Amputation Incidence Decreases Both in Non-Diabetic and in Diabetic Patients in Helsinki

Eskelinen

Albäck

et al. 2006

Scand J Surg

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“…72,74,75 As diabetics have a pattern of disease that includes a heavy burden of disease in tibioperoneal arteries, the level of distal anastomosis has proved to be a much weaker predictor of graft failure than conduit quality.…”

Section: Tibial-pedal Diseasementioning

confidence: 99%

Surgical Intervention for Peripheral Arterial Disease

Vartanian

Conte

2015

Circulation Research

105

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The prevalence of peripheral arterial disease (PAD) is increasing worldwide, with recent global estimates exceeding 200 million people. Advanced PAD leads to a decline in ambulatory function and diminished quality of life. In its most severe form, critical limb ischemia, rest pain, and tissue necrosis are associated with high rates of limb loss, morbidity, and mortality. Revascularization of the limb plays a central role in the management of symptomatic PAD. Concomitant with advances in the pathogenesis, genetics, and medical management of PAD during the last 20 years, there has been an ongoing evolution of revascularization options. The increasing application of endovascular techniques has resulted in dramatic changes in practice patterns and has refocused the question of which patients should be offered surgical revascularization. Nonetheless, surgical therapy remains a cornerstone of management for advanced PAD, providing versatile and durable solutions to challenging patterns of disease. Although there is little high-quality comparative effectiveness data to guide patient selection, existing evidence suggests that outcomes are dependent on definable patient factors such as distribution of disease, status of the limb, comorbid conditions, and conduit availability. As it stands, surgical revascularization remains the standard against which emerging percutaneous techniques are compared. This review summarizes the principles of surgical revascularization, patient selection, and expected outcomes, while highlighting areas in need of further research and technological advancement.

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“…Es, por tanto, una enfermedad subestimada y subdiagnosticada [5][6][7] . Los factores de riesgo relacionados con su desarrollo son clásicamente, la hipertensión arterial (HTA), el tabaquismo, la diabetes y la hipercolesterolemia 7,8 . Sin embargo, existen diferencias en la prevalencia de estos factores de riesgo según el territorio vascular analizado.…”

Section: Introductionunclassified

Evaluación de la permeabilidad posterior a procedimientos endovasculares para pacientes con obstrucciones arteriales en miembros inferiores

et al. 2018

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Citar como: Ceballos OE, Márquez JA, Messier J, Charry JP, González M. Evaluación de la permeabilidad posterior a procedimientos endovasculares para pacientes con obstrucciones arteriales en miembros inferiores. Rev Colomb Cir. 2018;33:280-4 ResumenIntroducción. La enfermedad arterial periférica es una patología de difícil diagnóstico dado que su manifestación, en general, es asintomática, hecho que condiciona el avance significativo en su historia natural y el diagnóstico en estadio avanzado en la mayoría de los casos. Su prevalencia varía entre 3 y 18, mayor que la percibida por los profesionales de la salud, así como sus repercusiones clínicas, sociales y económicas, convirtiéndola en un importante problema de salud. Materiales y métodos. Estudio de cohorte retrospectiva con pacientes llevados a procedimiento endovascular para manejo de obstrucciones arteriales en miembros inferiores entre febrero de 2010 y agosto de 2016, en el que se evaluó la nueva obstrucción arterial en un seguimiento a un año. Se realizó un análisis de supervivencia no paramétrico a través del método de Kaplan-Meier para describir la frecuencia (tasa de incidencia e incidencia acumulada) de nueva obstrucción arterial. Resultados. Ingresaron 102 pacientes de 183 llevados a angioplastia, con edad promedio de 70,7 años (DE: 9,6) y predominio del sexo masculino con 56 pacientes (54,9 %). Durante el primer año de seguimiento, 18 pacientes (17,7 %) presentaron reestenosis (tasa de incidencia de 19,9 eventos por cada 100 pacientes al año). El mayor periodo de reestenosis fueron los primeros 120 días del seguimiento, con posterior estabilidad y presentación de mayor tasa de reestenosis nuevamente en los últimos 120 días del seguimiento, y en pacientes con intervención mixta (supra e infragenicular). Conclusión. La incidencia de reestenosis al año fue del 17,7 %, con permeabilidad superior al 80 %. Los procedimientos endovasculares son una estrategia segura que ofrece resultados similares a los reportados en la literatura.

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Graft patency and clinical outcome of femorodistal arterial reconstruction in diabetic and non-diabetic patients: Results of a multicentre comparative analysis

Cited by 93 publications

References 17 publications

Major Amputation Incidence Decreases Both in Non-Diabetic and in Diabetic Patients in Helsinki

Major Amputation Incidence Decreases Both in Non-Diabetic and in Diabetic Patients in Helsinki

Surgical Intervention for Peripheral Arterial Disease

Evaluación de la permeabilidad posterior a procedimientos endovasculares para pacientes con obstrucciones arteriales en miembros inferiores

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