Document Detail


Does diabetes mellitus play a role in restenosis and patency rates following lower extremity peripheral arterial revascularization? A critical overview.
MedLine Citation:
PMID:  18411027     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with diabetes mellitus (DM) are at increased risk of developing lower extremity peripheral arterial disease (PAD). The effect of DM on restenosis and patency rates in patients with PAD undergoing surgical revascularization or percutaneous interventions has not been fully clarified. We therefore critically reviewed the role of DM in restenosis, as well as primary and secondary patency rates in these patients. We searched Medline for studies investigating the effect of DM on restenosis (primary and secondary patency) rates in patients undergoing surgical/percutaneous interventions for the treatment of lower extremity PAD. Search terms used were "diabetes and peripheral arterial disease," "angioplasty," "restenosis," "revascularization," "patency rates," and "in-stent restenosis." Diabetic patients with PAD have similar restenosis, primary patency, and secondary patency rates compared with nondiabetic patients. However, mortality and amputation rates are increased in patients with DM. This increased risk of mortality and amputation may distort the estimation of restenosis and patency rates. Strict glucose control should be implemented in diabetic patients. Additionally, the use of antiplatelet agents and statins may have a beneficial effect on restenosis and patency rates. The role of radiation therapy in preventing restenosis remains to be determined. Patients with PAD and DM should receive optimal medical therapy to improve cardiovascular outcome and decrease functional decline. The direct involvement of vascular surgeons in the management of PAD patients is essential to reduce the incidence of cardiovascular events and mortality rates.
Authors:
Kosmas I Paraskevas; Daryll M Baker; Alfonso Pompella; Dimitri P Mikhailidis
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-04-14
Journal Detail:
Title:  Annals of vascular surgery     Volume:  22     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  481-91     Citation Subset:  IM    
Affiliation:
Department of Clinical Biochemistry, Royal Free Hospital, Royal Free Medical School, University College of London, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Amputation
Cardiovascular Agents / therapeutic use*
Constriction, Pathologic
Diabetes Complications / etiology*,  mortality,  physiopathology,  therapy
Diabetes Mellitus / mortality,  physiopathology,  therapy*
Humans
Hypoglycemic Agents / therapeutic use*
Lower Extremity / blood supply*
Peripheral Vascular Diseases / etiology*,  mortality,  physiopathology,  therapy
Radiotherapy / methods
Recurrence / prevention & control
Treatment Outcome
Vascular Patency*
Vascular Surgical Procedures*
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Hypoglycemic Agents

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