title: Major adverse events, six months after endovascular revascularization for critical limb ischemia in diabetic patients.
abstract: BACKGROUND
  This prospective study aimed to evaluate the detailed outcomes of diabetic patients with critical limb ischemia, six months after percutaneous transluminal angioplasty and appropriate multidisciplinary wound care.
  
  
  METHODS
  Totally, 45 consecutive patients (50 limbs) were enrolled and then divided into two groups according to the healing of ulcers. The endpoints were ulcer healing and major adverse events including amputation, mortality, and cardiac or cerebral morbidities, during a six- month follow-up period.
  
  
  RESULTS
  During six months follow-up, major amputation was performed for four of 50 limbs (8.0%). A total of nine (20%) patients died and the leading cause was cardiac death (13.3 %). Also, stroke and non-fatal myocardial infarction occurred in three (6.7 %) and one (2.2 %) of the patients, respectively. Among the 29 (59.2 %) healed wounds, 22 (44.9 %) were completely closed. The patients with nonhealing wounds had a higher rate of dialysis (40% vs. 0 %, P-value < 0.001) and more ulcers with stage of D3 according to the Texas Wound Classification (60% vs. 31 %, P-value = 0.016). Other demographic, clinical, ulcer characteristics and procedural characteristics such as number and level of the treated lesions did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  Based on our findings, it seems that along with current usual therapeutic routines which focus on wound healing and limb salvage, more attention should be paid to simultaneous diagnostic assessments and treatment of cardiovascular disease in this group of patients during short-term follow- up.
authors: Tehran Heart Center, Interventional Cardiology Department, Tehran University of Medical Sciences, Tehran, Iran.
authors: Seyed Ebrahim
authors: SE
authors: Kassaian
authors: Mohammad-reza
authors: MR
authors: Mohajeri-Tehrani
authors: Alireza
authors: A
authors: Dehghan-Nayyeri
authors: Sepideh
authors: S
authors: Saroukhani
authors: Zohreh
authors: Z
authors: Annabestani
authors: Mohammad
authors: M
authors: Alidoosti
authors: Shapour
authors: S
authors: Shirani
authors: Abolfazl
authors: A
authors: Shojaei-Fard
authors: Behnam
authors: B
authors: Molavi
authors: Hamidreza
authors: H
authors: Poorhosseini
authors: Mojtaba
authors: M
authors: Salarifar
authors: Maryam
authors: M
authors: Aboee-Rad
authors: Mina
authors: M
authors: Pashang
authors: Bagher
authors: B
authors: Larijani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D017130:Angioplasty; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D048909:Diabetes Complications / Q000209:etiology* / Q000401:mortality; D017719:Diabetic Foot / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing