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Giornale Italiano di Chirurgia Vascolare 2003 March;10(1):15-25

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Endovascular treatment of critical limb ischemia in diabetic patients

Porcellini M., Del Guercio L., Cecere D., Spinetti F., Di Lella D., Bracale G.

Cattedra di Chirurgia Vascolare Università degli Studi di Napoli Federico II, Napoli


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Background. The influ­ence of dia­betes on ­limb sal­vage is a con­tro­ver­sial ques­tion. The aim of ­this ­study was to eval­u­ate the out­comes of dia­bet­ic ­patients and non-dia­bet­ic ­patients ­with crit­i­cal ­limb ische­mia under­go­ing arte­ri­al endo­vas­cu­lar pro­ce­dures.
Methods. The ­records of 33 con­sec­u­tive ­patients who had under­gone endo­vas­cu­lar treat­ment for ­limb-threat­en­ing ische­mia ­over the ­past 7 ­years, includ­ing dia­bet­ic ­patients (Group I; n=16) and non-dia­bet­ic ­patients (Group II; n=17), ­were ­reviewed.
Results. No sig­nif­i­cant dif­fer­enc­es ­were ­found ­between Group I and II ­patients ­with ­respect to age, gen­der, ­risk fac­tors, sur­gi­cal indi­ca­tions, pre­op­er­a­tive ­ankle-bra­chi­al indi­ces. The ­limb sal­vage ­rates for Group I and II ­patients 30 ­days ­after treat­ment ­were 77.8% and 94.4% (p = n.s.), respec­tive­ly. Of 4 ear­ly ampu­ta­tions in the dia­bet­ic ­group, 3 ­were per­formed in ­limbs ­with pat­ent revas­cu­lar­isa­tion. There was no pro­ce­dure-relat­ed ­death (<30 ­days). After a ­median fol­low-up of 25 ­months (­range 9-84 ­months) in dia­bet­ic ­patients and 30 ­months (­range 7-72 ­months) in non-dia­bet­ic ­patients, the ­limb sur­vi­val ­rates ­were 66.7% and 83.3% (p = not sig­nif­i­cant). Three (18.7%) ­late ­deaths ­occurred in Group I and 1 (5.9%) in Group II ­patients (p = not sig­nif­i­cant) ­from car­diac dis­ease or can­cer.
Conclusions. The ­results of arte­ri­al endo­vas­cu­lar ther­a­py in dia­bet­ic ­patients ­showed ­limb-sal­vage ­rates sim­i­lar to ­those ­found in non-dia­bet­ic ­patients.

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