Authors: Irene Bargellini Pasquale Petruzzi Alessia Scatena Roberto Cioni Antonio Cicorelli Claudio Vignali Loredana Rizzo Alberto Piaggesi Carlo Bartolozzi
Publish Date: 2008/05/29
Volume: 31, Issue: 4, Pages: 713-722
Abstract
The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty in a series of diabetic patients with limbthreatening ischemia From July 2003 to December 2007 60 consecutive diabetic patients M/F = 41/19 mean age 694 ± 94 years with Fontaine stage IV critical limb ischemia not suitable for surgical recanalization underwent primary infrainguinal subintimal angioplasty The technical success perioperative morbidity and mortality and clinical success defined by ulcer healing were evaluated Kaplan–Meier lifetable analysis was obtained for cumulative clinical success limb salvage and survival rates The procedure was technically successful in 55 of 60 917 patients in 5 cases we were not able to achieve a reentry Periprocedural mortality was 5 3 patients three patients 5 required major amputation periprocedurally Mean followup was 23 months range 0–48 months On an intentiontotreat basis the limb salvage rate was 933 56/60 patients ulcer healing was observed in 45 of 60 75 patients and it was significantly p 005 associated with serum creatinine and HbA1c levels diabetes duration and infrapopliteal recanalization One and threeyear cumulative survival rates were 915 and 831 respectively serum creatinine levels patient age and clinical success were significant predictors of survival In conclusion infrainguinal primary subintimal angioplasty is a safe and effective treatment in diabetic patients with limbthreatening ischemia not suitable for surgical recanalization This procedure is aimed to create a “temporary bypass” that facilitates ulcer healing
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