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Exp Clin Endocrinol Diabetes 2014; 122(01): 50-54
DOI: 10.1055/s-0033-1361102
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Outcome of Percutaneous Transluminal Angioplasty in Diabetic Patients with Critical Limb Ischaemia

J. H. An   *
1   Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
,
Y.-M. Jang   *
1   Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
,
K.-H. Song
1   Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
,
S. K. Kim
1   Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
,
S. W. Park
2   Department of Radiology, Konkuk University School of Medicine, Seoul, Korea
,
H.-G. Jung
3   Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea
,
D.-L. Kim
1   Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

received 02 May 2013
first decision 10 October 2013

accepted 04 November 2013

Publication Date:
24 January 2014 (online)

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Abstract

Objective:

We investigated the clinical outcome of percutaneous transluminal angioplasty (PTA) which has not been fully established in diabetic patients with critical limb Ischaemia (CLI) compared with non-diabetics.

Design and patients:

A total of 73 limbs of 52 patients (50 limbs of 34 diabetic patients and 23 limbs of 18 non-diabetics) who underwent PTA for CLI (Rutherford-Becker category 4, 5 or 6) were enrolled. Rates of amputation and restenosis, and ankle brachial index (ABI), were assessed before and after PTA during a 36-month follow-up period.

Results:

Diabetic patients had a higher rate of major amputations after PTA (10 vs. 0%, P<0.05); however, total amputation (12.0 vs. 8.7%, P=0.62) and restenosis rates (4.0 vs. 8.7%, P=0.38) were not significantly different compared with non-diabetic patients. ABI at 3 months after PTA was significantly improved in both diabetic and non-diabetic patients (0.70±0.20 vs. 0.93±0.19, P<0.01 in diabetic patients; 0.69±0.25 vs. 0.92±0.17, P<0.01 in non-diabetics). Improved ABI was maintained for 36 months in both groups and did not show a significant difference (0.88±0.21 vs. 0.89±0.20, P=0.89).

Conclusion:

Our results, showing that the outcome of PTA in diabetic patients is not inferior to that in non-diabetics, suggest the potential benefit of primary PTA, instead of bypass surgery, for CLI in diabetic patients who are at high risk of perioperative complications.

Key words

critical limb ischaemia - peripheral arterial disease - percutaneous transluminal angioplasty - diabetes

* First 2 authors equally contributed to this study.


 

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