TY - JOUR
T1 - Successful Revascularization has a Significant Impact on Limb Salvage Rate and Wound Healing for Patients with Diabetic Foot Ulcers
T2 - Single-Centre Retrospective Analysis with a Multidisciplinary Approach
AU - Caetano, António Proença
AU - Conde Vasco, Inês
AU - Veloso Gomes, Filipe
AU - Costa, Nuno Vasco
AU - Luz, José Hugo
AU - Spaepen, Erik
AU - Formiga, Ana
AU - Coimbra, Élia
AU - Neves, José
AU - Bilhim, Tiago
PY - 2020/10
Y1 - 2020/10
N2 - Purpose: Analyze the impact of endovascular revascularization on major amputation rates and wound healing for patients with diabetic foot ulcers (DFUs). Materials and Methods: Single-center retrospective study from 2014–2018 including 314 patients with DFUs submitted to endovascular revascularizations. Group A—patients with a successful endovascular revascularization (n = 285; 90.8%); Group B—patients submitted to a failed attempt of endovascular revascularization (n = 29; 9.2%). Baseline data were not significantly different between the 2 groups (p > 0.05). Both groups were compared regarding: major amputation rates; wound healing, mortality and adverse events. Survival and regression analyses were used. Results: Mean follow-up time was 734.1 ± 610.2 days. Major amputation rates were 3.9% versus 24.1% (p < 0.0001) and complete wound healing was 53.7% versus 20.7% (p < 0.0001) for patients from Group A versus Group B, respectively. Major adverse events were registered in 2 patients (one from each group); minor adverse events included 10 patients from Group A and 2 patients from Group B (p = 0.3654). Major amputation rates were: 3.9% versus 27.5% at 1 year; 4.6% versus 27.5% at 2–5 years for Group A versus Group B, respectively (p < 0.0001). Survival rates were: 87.8% at 1 year; 84.4% at 2 years; and 77.9% at 5 years with no significant differences between groups. Predictors for major amputation included failed revascularization (p < 0.0001), older age (p = 0.0394), prior stroke (0.0018), dialysis (0.0476). Predictors for mortality included older age (p < 0.0001) and coronary artery disease (p = 0.0388). Conclusion: Endovascular revascularization for patients with DFUs is safe and has a significant impact on limb salvage and wound healing.
AB - Purpose: Analyze the impact of endovascular revascularization on major amputation rates and wound healing for patients with diabetic foot ulcers (DFUs). Materials and Methods: Single-center retrospective study from 2014–2018 including 314 patients with DFUs submitted to endovascular revascularizations. Group A—patients with a successful endovascular revascularization (n = 285; 90.8%); Group B—patients submitted to a failed attempt of endovascular revascularization (n = 29; 9.2%). Baseline data were not significantly different between the 2 groups (p > 0.05). Both groups were compared regarding: major amputation rates; wound healing, mortality and adverse events. Survival and regression analyses were used. Results: Mean follow-up time was 734.1 ± 610.2 days. Major amputation rates were 3.9% versus 24.1% (p < 0.0001) and complete wound healing was 53.7% versus 20.7% (p < 0.0001) for patients from Group A versus Group B, respectively. Major adverse events were registered in 2 patients (one from each group); minor adverse events included 10 patients from Group A and 2 patients from Group B (p = 0.3654). Major amputation rates were: 3.9% versus 27.5% at 1 year; 4.6% versus 27.5% at 2–5 years for Group A versus Group B, respectively (p < 0.0001). Survival rates were: 87.8% at 1 year; 84.4% at 2 years; and 77.9% at 5 years with no significant differences between groups. Predictors for major amputation included failed revascularization (p < 0.0001), older age (p = 0.0394), prior stroke (0.0018), dialysis (0.0476). Predictors for mortality included older age (p < 0.0001) and coronary artery disease (p = 0.0388). Conclusion: Endovascular revascularization for patients with DFUs is safe and has a significant impact on limb salvage and wound healing.
KW - Below-the-knee disease
KW - Critical limb ischemia (CLI)
KW - Diabetic foot disease
KW - Diabetic foot infections
KW - Diabetic foot ulcers (DFUs)
KW - Diabetic foot wounds
KW - Infragenicular arteries
KW - Infrapopliteal arteries
KW - Limb salvage
KW - Major amputation
KW - Percutaneous transluminal angioplasty (PTA)
KW - Peripheral artery disease
KW - Ulceration of the foot
UR - http://www.scopus.com/inward/record.url?scp=85088819706&partnerID=8YFLogxK
U2 - 10.1007/s00270-020-02604-4
DO - 10.1007/s00270-020-02604-4
M3 - Article
C2 - 32743744
AN - SCOPUS:85088819706
SN - 0174-1551
JO - Cardiovascular And Interventional Radiology
JF - Cardiovascular And Interventional Radiology
ER -