Comparison of clinical outcome of infrapopliteal angioplasty between Korean diabetic and non-diabetic patients with critical limb ischemia.

Abstract

BACKGROUND: Although infrapopliteal angioplasty may salvage the majority of limbs under threat of amputation, this procedure is still limited in diabetic patients. The purpose of the present study was to compared the outcomes of infrapopliteal angioplasty between Korean diabetic patients and non-diabetic patients with critical lower limb ischemia (CLI).

METHODS AND RESULTS: Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 108 limbs of 93 patients (71 male; mean age, 68 years, range, 27-91 years) with CLI (Rutherford-Becker category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed. Median follow-up was 30 months (range, 1-93 months). The number of diabetic patients was 70 (75%). There were no significant differences between the 2 groups in technical success rate (66% vs. 84%, P = 0.133) and primary clinical success rate (81% vs. 92%, P = 0.234). Kaplan-Meier analysis showed that diabetic patients had a higher frequency of poor primary patency (P = 0.012) during 2-year follow-up, but that there were no significant differences between the 2 groups in terms of limb salvage (P = 0.930), and survival (P = 0.459).

CONCLUSIONS: Diabetic patients had an unfavorable 2-year primary patency compared with non-diabetic patients. There were no significant differences, however, between the 2 groups in terms of technical success rate, primary clinical success rate, 2-year limb salvage rate or overall survival.