Author(s): Zayed HA, Fassiadis N, Jones KG, Edmondson RD, Edmonds ME,
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Abstract AIM: Recent studies have shown that percutaneous transluminal angioplasty (PTA) can be safely performed as a day-case procedure. Many centers consider diabetes mellitus as a contraindication to day-case PTA. In this study, the safety and efficacy of 95 day-case PTA in 66 diabetic patients with critical leg ischemia (CLI) were evaluated. METHODS: Diabetic patients with CLI were assessed in a one-stop multidisciplinary outpatient clinic. Sixty-six outpatients with CLI deemed suitable for radiological intervention by non-invasive imaging (ultrasound angiology or magnetic resonance angiography) were scheduled for day-case PTA. RESULTS: PTA was initially successful in 63 out of 66 patients (95\%). In 3 patients (5\%), PTA was not possible because the lesion could not be balloon dilated or crossed with a guide wire. Clinically suspected first, second and third re-stenosis confirmed by non-invasive studies occurred in 20 out of 63 (31\%), 7 out of 20 (35\%) and 2 out of 7 (28\%) patients, respectively. Following PTA, debridement was performed in 11 patients (17\%), minor amputation in 8 (13\%) and major amputation in 3 (5\%). Relief of the primary symptom of rest pain or healing of ulcers was achieved in 23 out of 32 (72\%) and 25 out of 27 (92.5\%) patients, respectively. No peri-interventional morbidity or mortality was encountered. CONCLUSION: PTA is feasible and safe as a day-case procedure in diabetic patients with CLI. Re-stenosis can be managed by repeat day-case PTA.
This article was published in Int Angiol
and referenced in General Medicine: Open Access