Outcome of percutaneous transluminal angioplasty in diabetic patients with critical limb ischaemia.
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.


METHODS
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).


CONCLUSIONS
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.
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
J H
JH
An
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Y-M
YM
Jang
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
K-H
KH
Song
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
S K
SK
Kim
Department of Radiology, Konkuk University School of Medicine, Seoul, Korea.
S W
SW
Park
Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea.
H-G
HG
Jung
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
D-L
DL
Kim
D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D017130:Angioplasty; D055109:Ankle Brachial Index; D016638:Critical Illness; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome