The Impact of Diabetes on Current Revascularisation Practice and Clinical Outcome in Patients with Critical Lower Limb Ischaemia

Awad, Sherif; Karkos, C.D.; Serrachino-Inglott, F.; Cooper, NJ; Butterfield, John S.; Ashleigh, Ray; Akhtar, Nasim

doi:10.1016/j.ejvs.2005.12.019

Cited by 69 publications

(55 citation statements)

References 29 publications

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“…3,5,[15][16][17] The relative incidence of DM in our study population (48%) was well within this range. The optimal management of diabetic patients is still being defined.…”

Section: Discussionmentioning

confidence: 59%

Insulin use is associated with poor limb salvage and survival in diabetic patients with chronic limb ischemia

Dosluoglu

Lall

Nader

et al. 2010

Journal of Vascular Surgery

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Diabetic patients who present with limb ischemia can be subdivided into three distinct subgroups based on their diabetic regimen. The survival and LS rates of those controlled with diet or OM are nearly identical to nondiabetics, both of which are significantly better than OM+INS or INS. The PP rate in endovascular-treated patients is worse in patients who are on insulin. Being on insulin is independently associated with decreased survival and limb loss but not PP.

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“…3,5,[15][16][17] The relative incidence of DM in our study population (48%) was well within this range. The optimal management of diabetic patients is still being defined.…”

Section: Discussionmentioning

confidence: 59%

Insulin use is associated with poor limb salvage and survival in diabetic patients with chronic limb ischemia

Dosluoglu

Lall

Nader

et al. 2010

Journal of Vascular Surgery

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“…11 A British study analyzing current revascularization practices and outcomes for nondiabetic and diabetic patients with CLI found similar results: an aggressive multidisciplinary approach yielded comparable limb salvage, amputation-free survival, mortality, and major amputation rates in both groups. 12 Second, we included outpatient data, which accounts for a significant portion of patients who had PAD-related procedures. Endovascular therapies are being increasingly performed as ambulatory procedures.…”

Section: Discussionmentioning

confidence: 99%

An analysis of the outcomes of a decade of experience with lower extremity revascularization including limb salvage, lengths of stay, and safety

Egorova

Guillerme

Gelijns

et al. 2010

Journal of Vascular Surgery

139

115

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Although patients today, whether treated for claudication or CLI, have more comorbidities, the rates of amputation, the procedural morbidity and mortality, and LOS have all significantly decreased. Other variables, including changes in medical management and wound care, undoubtedly are important, but this change appears to be largely due to the widespread and successful use of endovascular LER or to earlier intervention, or both, driven by the safety of these techniques.

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“…This study also did not use the technique described by Balas et al which approaches flush occlusions of the SFA with a combination of open surgery and endovascular techniques [22].…”

Section: Discussionmentioning

confidence: 99%

Transluminal versus Subintimal Angioplasty for Management of Critical Limb Ischemia Patients with Femoropopliteal Occlusive Disease

Foad¹,

Eldaly²,

Eldin³

et al. 2015

J Health Edu Res Dev

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AimComparison between intraluminal and subintimal angioplasty with review of technique, factors affecting the success and complications with special emphasis on factors that could predict the wire route meanwhile using simple techniques. MethodsThis is a non-randomized study with prospectively collected data that included 159 patients presented from 2011 to 2014 to the vascular surgery department with critical chronic lower limb ischemia due to atherosclerotic femoropopliteal occlusive disease for whom percutaneous angioplasty was done. Patients presenting with nonsalvageable limbs requiring primary major amputation and non-atherosclerotic causes of CLI were excluded. Results 75.5% of the lesionswere crossed transluminally while 19.5% of the lesions were crossed subintimally. In 8 cases (5%) the lesion could not be passed. The overall technical success to pass the lesion was 95%. On 24 months follow up, 1ry patency, 2ry patency, limb salvage in intraluminal group are 56.8%, 60.2% and 66.1% respectively while in subintimal group 46.7%, 46.7% and 60% respectively. Subintimal was more in the TASC D, lesion more than 10 cm and in contralateral access (P value was<0.05). There were no statistically significant differences between intraluminal and subintimal angioplasty regarding the outcome (Patency and limb salvage). ConclusionsThe passage of the wire is affected by length of the lesion, the TASC II classification of the lesion and access site with the subintimal passage was more in Lesion more than 10 cm, TASC D lesions and in contralateral access. These factors can be used prospectively as predictors for passage of the wire whether intraluminal or subintimal. In spite of the technical differences between the intraluminal and subintimal passage, yet they show no significant statistical differences regarding the outcome (patency and limb salvage). Hence both should be used as part of vascular armamentarium for revascularization in such frail patients.

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The Impact of Diabetes on Current Revascularisation Practice and Clinical Outcome in Patients with Critical Lower Limb Ischaemia

Cited by 69 publications

References 29 publications

Insulin use is associated with poor limb salvage and survival in diabetic patients with chronic limb ischemia

Insulin use is associated with poor limb salvage and survival in diabetic patients with chronic limb ischemia

An analysis of the outcomes of a decade of experience with lower extremity revascularization including limb salvage, lengths of stay, and safety

Transluminal versus Subintimal Angioplasty for Management of Critical Limb Ischemia Patients with Femoropopliteal Occlusive Disease

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