Comparison of diabetic and non-diabetic patients undergoing endovascular revascularization for peripheral arterial disease.

ABSTRACT

OBJECTIVE: Peripheral arterial disease (PAD) is associated with poor outcomes. We assessed the clinical outcomes of diabetic versus non-diabetic patients with PAD who underwent peripheral transluminal angioplasty (PTA). METHODS: The outcomes of 239 consecutive patients with symptomatic PAD who underwent PTA were analyzed. Restenosis and clinical outcomes were assessed at a follow-up of 2 years. RESULTS: Diabetic patients had a higher percentage of wound as the initial diagnosis for PTA (72.7% vs. 14.2%; P<.001), chronic kidney disease (26.7% vs. 6.3%; P<.01), need for dialysis (19.3% vs. 3.1%; P<.01), and coronary artery disease (67.6% vs. 50.7%; P=.02). Infrapopliteal PTA was more commonly performed in the diabetic group (70.4% vs. 25.3%; P<.001). Diabetic patients had lower rates of angiographic follow-up at 8 months (38.6% vs. 60.3%; P<.01). Diabetic patients had higher binary restenosis (54.4% vs. 31.5%; P=.02) and had a trend toward a higher incidence of total occlusion (34.0% vs. 19.5%; P=.08). At 2-year follow-up, the amputation rate was higher in the diabetic group (24.4% vs. 1.5%; P<.001) despite PTA. CONCLUSION: Diabetic patients more frequently presented with critical limb ischemia compared with non-diabetic patients and had higher rates of restenosis and amputation at 2 years following standard PTA. Improved therapies are needed for this high-risk group of patients.