title: Impact of Diabetes Mellitus on Critical Limb Ischemia With Below the Knee Disease: Japan Below-the-Knee Artery Treatment Subanalysis.
abstract: BACKGROUND
  A strong association exists between diabetes mellitus and critical limb ischemia.
  
  
  RESULTS
  We performed endovascular therapy on 1060 limbs in 884 patients with below knee lesions only. The patients were divided into diabetes (DG) and nondiabetes groups (NDG). Limb salvage was poorer in the DG (79% vs 89%,P= .0061). No significant difference was observed in mortality, amputation-free survival (AFS), and target vessel revascularization (TVR). Multivariate analysis revealed diabetes status, infection, poor activity of daily living (ADL), younger age, and procedure failure as independent predictors of major amputation in DG. In the NDG, procedure failure was the predictor, and younger age and poor ADL showed tendency of major amputation.
  
  
  CONCLUSIONS
  Mortality, AFS, and TVR showed no significant difference between the 2 groups, but major amputation was more frequent in DG. Not only revascularization but also infection and diabetes control were very important for limb salvage in DG.
authors: Cardiovascular Center, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, Miyagi, Japan.
authors: Kenji
authors: K
authors: Suzuki
authors: Cardiovascular Division, Kansai Rosai Hospital, Inabaso, Amagasaki, Hyogo, Japan.
authors: Osamu
authors: O
authors: Iida
authors: Cardiovascular Center, Kikuna Memorial Hospital, Kikuna, Kohoku, Yokohama, Kanagawa, Japan.
authors: Yasutaka
authors: Y
authors: Yamauchi
authors: Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, Japan.
authors: Masatsugu
authors: M
authors: Nakano
authors: Department of Cardiology, Kokura Memorial Hospital, Kibune-cho, Kita-ku, Kokura, Kitakyushu, Fukuoka, Japan.
authors: Yoshimitsu
authors: Y
authors: Soga
authors: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho, Nishinomiya, Hyogo, Japan.
authors: Daizo
authors: D
authors: Kawasaki
authors: Department of Circulatory Organs, Kyoto University Hospital, Kawahara-cho, Shogo-in, Sakyo-ku, Kyoto, Kyoto, Japan.
authors: Junichi
authors: J
authors: Tazaki
authors: Department of Vascular Surgery, Matsuyama Red Cross Hospital, Bunkyo-cho, Matsuyama, Ehime, Japan.
authors: Terutoshi
authors: T
authors: Yamaoka
authors: Department of Cardiology, Japanese Red Cross Fukuoka Hospital, Okusu-cho, Minami-ku, Fukuoka, Fukuoka, Japan.
authors: Nobuhiro
authors: N
authors: Suematsu
authors: Department of Cardiology, Shin-Koga Hospital, Tenjin-cho, Kurume, Fukuoka, Japan.
authors: Yoshiaki
authors: Y
authors: Shintani
authors: Department of Advanced PAD Therapeutics, Shinshu University Hospital, Asahi, Matsumoto, Nagano, Japan.
authors: Yusuke
authors: Y
authors: Miyashita
authors: Cardiovascular Center, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, Miyagi, Japan.
authors: Naoto
authors: N
authors: Inoue
authors: Cardiovascular Center, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, Miyagi, Japan.
authors: Taiichiro
authors: T
authors: Meguro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016638:Critical Illness; D003925:Diabetic Angiopathies / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007564:Japan; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: critical limb ischemia; diabetes mellitus; endovascular therapy; peripheral arterial disease