Document Detail


Percutaneous transluminal angioplasty in severe diabetic foot ischemia: outcomes and prognostic factors.
MedLine Citation:
PMID:  16369199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the outcomes of severe ischemic diabetic foot ulcers for which percutaneous transluminal angioplasty (PTA) was considered as the first-line vascular procedure. Factors associated with successful PTA were sought. RESEARCH DESIGN AND METHODS: In 32 consecutive diabetic patients with foot ulcers and severe limb ischemia, PTA was performed if feasible; if not, primary bypass grafting was done when feasible. All patients were followed until healing or for at least one year. Patients with worsening ulcers after PTA underwent bypass grafting. Clinical and angiographic factors influencing outcomes after PTA were sought by univariate and multivariate analysis. RESULTS: PTA was done in 25 of the 32 (78%) patients, and considered clinically successful in 13 (52%). After 1 year, the healing rate was 70% and the limb salvage rate 90%. Successful PTA was significantly associated with a higher post-PTA transcutaneous oxygen pressure (P = 0.03) and presence of at least one patent pedal vessel (P = 0.03) in the univariate analysis; only a patent pedal vessel was significant in the multivariate analysis. CONCLUSION: Primary PTA in diabetic patients with severe ischemic foot ulcers provides similar outcomes to usual results obtained in severe ischemia in absence of diabetes. The presence of one patent pedal vessel on arteriography before PTA is the best prognostic factor.
Authors:
S Jacqueminet; A Hartemann-Heurtier; R Izzillo; P Cluzel; J L Golmard; G Ha Van; F Koskas; A Grimaldi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes & metabolism     Volume:  31     ISSN:  1262-3636     ISO Abbreviation:  Diabetes Metab.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-12-21     Completed Date:  2006-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607599     Medline TA:  Diabetes Metab     Country:  France    
Other Details:
Languages:  eng     Pagination:  370-5     Citation Subset:  IM    
Affiliation:
Service de diabétologie et métabolisme, Hôpital Pitié-Salpétrière, Paris, France. jacqueminet@psl.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Diabetes Mellitus, Type 1 / therapy
Diabetes Mellitus, Type 2 / therapy
Diabetic Foot / physiopathology,  radiography,  surgery*
Female
Foot Ulcer / epidemiology,  surgery
Humans
Male
Patient Selection
Prognosis
Smoking
Treatment Outcome
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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