open access

Vol 27, No 5 (2020)
Original articles — Clinical cardiology
Published online: 2018-10-19
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Long term outcomes in diabetic patients treated with atherectomy for peripheral artery disease

Adam J. Janas, Krzysztof P. Milewski, Piotr P. Buszman, Wojciech Trendel, Aleksandra Kolarczyk-Haczyk, Mariusz Hochuł, Maciej Pruski Jr., Wojciech Wojakowski, Paweł E. Buszman, Radosław S. Kiesz
DOI: 10.5603/CJ.a2018.0122
·
Pubmed: 30394507
·
Cardiol J 2020;27(5):600-607.

open access

Vol 27, No 5 (2020)
Original articles — Clinical cardiology
Published online: 2018-10-19

Abstract

Background: The prevalence of diabetes has increased significantly in well-developed countries during the last decade and it continues to grow. Diabetes increases the risk of restenosis in patients treated percutaneously for peripheral artery disease. The present study sought to compare outcomes of atherectomy treatment in diabetic (DM) vs. non-diabetic (nDM) patients suffering from peripheral artery disease.

Method:
Between 2008 and 2012, 204 revascularization atherectomy procedures were performed on arteries of the lower extremities. The endpoints included target lesion revascularization (TLR), amputation and death. The type of atherectomy (excisional-soft plaque, orbital-calcified plaque, with active aspiration — with a thrombus) was left to operator discretion.

Results:
This study contains 132 DM (66% male, age 68 ± 11.2 years) and 72 nDM (63% male, age 75 ± 11.3 years) subjects. DM were younger but had a higher prevalence of coronary artery disease (DM: 91% vs. nDM: 62%, p < 0.0001) and end-stage renal disease (DM: 22% vs. nDM: 2.5%, p < 0.0001). There were no differences in critical limb ischemia between the groups (DM: 21% vs. nDM: 12%, p = = 0.13). Mean time of follow-up was 384 and 411 days in DM and nDM, respectively (p = 0.43). There were no significant differences in TLR (DM: 15.2% vs. nDM: 22.2%, p = 0.249), amputations (DM: 3.0% vs. nDM: 1.5%, p = NS) or death rates (DM: 2.2% vs. nDM: 2.7%, p = NS). Kaplan-Mayer analysis showed no significant differences between the groups in the time to TLR, amputation or death.

Conclusions:
Plaque modification with adjusted atherectomy appears to have similar outcomes in
diabetic as well as in non-diabetic patients. Nonetheless, a randomized study would be warranted to
confirm the findings of the current study.

Abstract

Background: The prevalence of diabetes has increased significantly in well-developed countries during the last decade and it continues to grow. Diabetes increases the risk of restenosis in patients treated percutaneously for peripheral artery disease. The present study sought to compare outcomes of atherectomy treatment in diabetic (DM) vs. non-diabetic (nDM) patients suffering from peripheral artery disease.

Method:
Between 2008 and 2012, 204 revascularization atherectomy procedures were performed on arteries of the lower extremities. The endpoints included target lesion revascularization (TLR), amputation and death. The type of atherectomy (excisional-soft plaque, orbital-calcified plaque, with active aspiration — with a thrombus) was left to operator discretion.

Results:
This study contains 132 DM (66% male, age 68 ± 11.2 years) and 72 nDM (63% male, age 75 ± 11.3 years) subjects. DM were younger but had a higher prevalence of coronary artery disease (DM: 91% vs. nDM: 62%, p < 0.0001) and end-stage renal disease (DM: 22% vs. nDM: 2.5%, p < 0.0001). There were no differences in critical limb ischemia between the groups (DM: 21% vs. nDM: 12%, p = = 0.13). Mean time of follow-up was 384 and 411 days in DM and nDM, respectively (p = 0.43). There were no significant differences in TLR (DM: 15.2% vs. nDM: 22.2%, p = 0.249), amputations (DM: 3.0% vs. nDM: 1.5%, p = NS) or death rates (DM: 2.2% vs. nDM: 2.7%, p = NS). Kaplan-Mayer analysis showed no significant differences between the groups in the time to TLR, amputation or death.

Conclusions:
Plaque modification with adjusted atherectomy appears to have similar outcomes in
diabetic as well as in non-diabetic patients. Nonetheless, a randomized study would be warranted to
confirm the findings of the current study.

Get Citation

Keywords

atherectomy, diabetes mellitus, peripheral artery disease, critical limb ischemia, claudication, below the knee, above the knee

About this article
Title

Long term outcomes in diabetic patients treated with atherectomy for peripheral artery disease

Journal

Cardiology Journal

Issue

Vol 27, No 5 (2020)

Pages

600-607

Published online

2018-10-19

DOI

10.5603/CJ.a2018.0122

Pubmed

30394507

Bibliographic record

Cardiol J 2020;27(5):600-607.

Keywords

atherectomy
diabetes mellitus
peripheral artery disease
critical limb ischemia
claudication
below the knee
above the knee

Authors

Adam J. Janas
Krzysztof P. Milewski
Piotr P. Buszman
Wojciech Trendel
Aleksandra Kolarczyk-Haczyk
Mariusz Hochuł
Maciej Pruski Jr.
Wojciech Wojakowski
Paweł E. Buszman
Radosław S. Kiesz

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