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Abstract:

The purpose of the study is to evaluate the immediate and long-term effectiveness of percutaneous transluminal angioplasty (PTA) in patients with diabetes mellitus (DM) and critical lower limbs ischemia (CLLI).

Since November 2004 till February 2008 42 PTA were performed in 40 patients with CLLI; 28 (70%) of them had ischemic ulceration, in 6 patients (15%) there were foot gangrene, and 6 patients suffered of ischemic rest pain. 30 patients (75%) had the insulin-dependent DM, 8 patients (20%) took antihyperglycemic drugs, 2 (5%) kept to antihyperglycemic diet. There were the following comorbidities: CAD - 30 patients (75%); arterial hypertension - 31 (77,5%); cerebrovascular insufficiency - 15 (37,5%); chronic renal failure - 8 (20%), and 3 patients (7,5%) were on chronic hemodialisis.

One patient (1,4%) had iliac localization of the lesion, 38 (51,4%) - femoropopliteal disease, and there were infrapopliteal lesions in 35 (47,3%) patients. There were prevalence of TASC type C and type D lesions (89,2%), and 81,5% of all infrapopliteal lesions were occlusions. Subintimal tracking was used in 31,5% of lesions. Stenting performed in 2 cases. Angiography success rate was 92,7% - 37 patients. Clinical improvement registered in 36 (90%) patients. 12-month follow-up showed absence of critical ischemia in 72,8% of cases. 

 

 

Reference

 

 

1.     Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur. J. Vasc. Endovasc. Surg. 2007; 33 (1): 39.

 

2.     Jonason T., Ringqvist I. Factors of prognosticimportance for subsequent rest pain in patient with intermittent claudication. Acta. Med.Scand. 1985; 218: 27-33.

 

3.     Hughson W.G., MannJ.I., Garrod A. Intermittent claudication: prevalence and risk factors,tent claudication: prevalence and risk factors. Br. Med.J. 1978; 1: 1379-1381.

 

 

4.     LoGerfo F.W., Gibbons G.W., PomposelliJ.F.B., Campbell D.R., Miller A., Freeman D.V.et al. Trends in the care of the diabetic foot.Expanded role of arterial reconstruction. Arch. Surg. 1992; 127: 617-620.

 

5.     Blair J.M., Gewertz B.L., Moosa H., Lu C.T.,Zarins C.K. Percutaneous transluminal angioplasty versus surgery for limb-threateningischemia.J. Vasc. Surg. 1989; 9 (5): 698-703.

6.     Treiman G.S., Treiman R.L., Ichikawa L., Van Allan R. Should percutaneous transluminal angioplasty be recommended for treatment of infrageniculate popliteal artery or tibioperoneal trunk stenosis?J. Vasc. Surg. 1995; 22 (4): 457-463, 464-465.

 

7.     Parsons R.E., Suggs W.D., Lee J.J., Sanchez L.A., Lyon R.T., Veith F.J. Percutaneous transluminal angioplasty for the treatment of limbthreatening ischemia: do the results justify anattempt before bypass grafting? / Vase. Surg. 1998; 28 (6): 1066-1071.

 

8.     Molloy K.J., Nasim A., London N.J., Naylor A.R., Bell PR., Fishwick G., Bolia A., Thornpson M.M. Percutaneous transluminal angioplasty in the treatment of critical limb ischemia.J. Endovasc. Ther. 2003; 10 (2): 298-303.

 

9.     Nasr M.K., McCarthy R.J., Hardman J., Chalmers A., Horrocks M. The increasing role ofpercutaneous transluminal angioplasty in theprimary management of critical limb ischaemia. Eur. J. Vasc. Endovasc. Surg. 2002; 23 (5):398-403.

 

 

10.   Adam D.J., Beard J.D., Cleveland T.T. Bypassversus angioplasty in severe ischaemia of theleg (BASIL): multicentre, randomised controlled trial. Lancet. 2005; 366 (9501):1925-1934.

 

11.   Faglia E., DallaP.L., Clerici G., ClerissiJ., Gra ziani L., Fusaro M., Gabrielli L., Losa S., Stella A., Gargiulo M., Mantero M., Caminiti M., Ninkovic S., Curci V., Morabito A. Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur. J. Vasc. Endovasc. Surg. 2005; 29 (6): 620-627.

 

12.   Bolia A., Miles K.A., Brennan J. et al. Percutaneous transluminal angioplasty of occlusions of the femoral and popliteal arteries by dissection. Cardiovasc. Intervent. Radiol. 1990; 13: 357-363.

 

13.   Rutherford R.B., Baker J.D., Ernst C., Johnston K.W., PorterJ.M., Ahn S.,Jones D.N. Recommended standards for reports dealing with lower extremity ischemia: revised version. [Erratum in: / Vase. Surg. 1997; 26 (3): 517-538.] J. Vasc. Surg. 2001; 33 (4): 805.

14.   Капутин М.Ю., Овчаренко Д.В., Сорока В.В. и др. Субинтимальная ангиопластика в лечении больных с критической ишемией нижних конечностей. Медицинский академический журнал. 2007; 6 (3): 103-108.

15.   Graziani L., Silvestro A., Bertone V., Manara E., Alicandri A., Parrinello G., Manganoni A. Percutaneous transluminal angioplasty is feasible and effective in patients on chronic dialysis with severe peripheral artery disease. Nephrol. Dial. Transplant. 2007; 22 (4): 1144-1149.

16.   Graziani L., Silvestro A., Bertone V., Manara E., Andreini R., Sigala A., Mingardi R., De Giglio R. Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur. J. Vasc. Endovasc. Surg. 2007; 33 (4): 453-460.

17.   Long-term mortality and its predictors in patients with critical leg ischaemia. The I.C.A.I. Group (Gruppo di Studio dell'Ischemia Cronica Critica degli Arti Inferiori). The Study Group of Criticial Chronic Ischemia of the Lower Exremities. Eur. J. Vasc. Endovasc. Surg. 1997; 14 (2): 91-95.

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