Comparison of Clinical outcomes of Infragenicular Angioplasty between diabetic and non-diabetic patients with Peripheral Arterial Occlusive DiseaseGamal W1*, Askary Z1 and Ibrahim M2
- Corresponding Author:
- Walid Gamal
Department of Vascular Surgery
Assiut University Hospital
Assiut University, Egypt
E-mail: [email protected]
Received Date: July 28, 2017; Accepted Date: August 04, 2017; Published Date: August 10, 2017
Citation: Gamal W, Askary Z, Ibrahim M (2017) Comparison of Clinical outcomes of Infragenicular Angioplasty between diabetic and nondiabetic patients with Peripheral Arterial Occlusive Disease. Angiol 5:201. doi:10.4172/2329-9495.1000201
Copyright: © 2017 Gamal W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Infragenicular angioplasty could salvage most of limbs under amputation impendence. We aim in our study to detect the results of infragenicular angioplasty in diabetic and non-diabetic patients with critical lower limb ischemia (CLI).
Patients and methods: Between April 2014 and May 2017,infragenicular angioplasty was carried out on 139 patients out of 154 patients (as 15 patients missed the follow up program or their data were lost) with CLI (Rutherford category 4,5 or 6) whom attended to The Vascular surgery Department of Qena University and Assiut University Hospitals. After obtaining informed written consent from all subjects, they were divided into diabetic group (n=62) and non-diabetic group (n=77).For all subjects pre-procedure, ankle brachial indexes (ABI) and computed tomography angiography (CTA) had been done. The percutaneous transluminal angioplasty (PTA) procedure was done alone or combined with stenting. The investigated outcomes comprised rest ABI, primary, secondary patency rates and finally limb-salvage rates 6, 12, 24 and 36 months after treatment.
Results: There were no significant differences between both groups in technical success rate (98.4 vs. 100%, P=0.133).Primary , secondary patency rates and limb salvage rates 6,12,24 and 36 months in both diabetic and non-diabetic groups were not significantly different (p value>0.001) The mean value of ankle brachial indexes was significantly increased after intervention (0.397 ± 0.125 versus 0.779 ± 0.137, t=-25.780, P<0.001) in diabetic group and (0.406 ± 0.101 versus 0.786 ± 0.121, t=-37.221, P<0.001) in non-diabetic group. Perioperative 30 day mortality was 0%. Major complications were groin hematoma in 7.3%, and formation of pseudo- aneurysms in 2.1% of subjects.
Conclusion: Infragenicular percutaneous angioplasty is a valuable option in CLI management with low risk of both morbidity and mortality. The efficiency and outcomes of interventional procedures in diabetic patients is similar to that in non-diabetics.