Objective:To investigate the influence of diabetes mellitus (DM) on revascularization (endovascular therapy and open surgery) for chronic critical lower limb ischemia (CLI).
Methods: The clinical data of 121 patients (130 affected limbs) undergoing revascularization for CLI in Chaoyang hospital within 3 years were retrospectively analyzed. Of the patients, 55 cases (60 affected limbs) with DM (DM group) were treated as follows: Twenty-seven limbs underwent artery shunting surgery, 9 limbs underwent percutaneous transluminal angioplasty (PTA), 20 limbs underwent PTA plus stent implantation and 4 limbs underwent artery shunting surgery combined with endovascular therapy. Sixty-six cases (70 affected limbs) of non-diabetic (NDM) patients (NDM group) were treated as follows: Twenty-eight limbs underwent artery shunting surgery, 10 limbs underwent PTA, 24 limbs underwent PTA plus stent implantation and 8 limbs underwent artery shunting surgery combined with endovascular therapy. All patients were followed up from 3 to 36 months, and the perioperative mortality, 1-year cumulative survival or limb salvage rate between the two groups were compared.
Results:Perioperative mortality in DM group and NDM group was 9.1% and 61%, respectively (P＞0.05); 1-year cumulative survival rate in DM group and NDM group was 881% and 93.1%, respectively (P＞0.05); Limb salvage rate in DM group and NDM group was 816% and 83.4%, respectively (P＞0.05).
Conclusions:DM has no influence on revascularization for CLI in respect to perioperative mortality, 1-year cumulative survival and limb salvage rate. Thus, these results suggest that revascularization shoud be aggressively perfomed in CLI patient with DM.