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Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   MAY 2013 , Volume 16 , Number 5; Page(s) 258 To 263.
 
Paper: 

MAJOR ADVERSE EVENTS, SIX MONTHS AFTER ENDOVASCULAR REVASCULARIZATION FOR CRITICAL LIMB ISCHEMIA IN DIABETIC PATIENTS

 
DOI: 

013165/AIM.003

 
Author(s):  KASSAIAN SEYED EBRAHIM, MOHAJERI TEHRANI MOHAMMADREZA*, DEHGHAN NAYYERI ALIREZA, SAROUKHANI SEPIDEH, ANNABESTANI ZOHREH, ALIDOOSTI MOHAMMAD, SHIRANI SHAPOUR, SHOJAEIFARD ABOLFAZL, MOLAVI BEHNAM, POURHOSEINI HAMIDREZA, SALARIFAR MOJTABA, ABOEE RAD MARYAM, PASHANG MINA, LARIJANI BAGHER
 
* ENDOCRINOLOGY AND METABOLISM RESEARCH CENTER, 5TH FLOOR, SHARIATI HOSPITAL, TEHRAN UNIVERSITY OF MEDICAL SCIENCES, NORTH KARGAR AVE., TEHRAN, IRAN
 
Abstract: 

BACKGROUND: This prospective study aimed to evaluate the detailed outcomes of diabetic patients with critical limb ischemia, six months after percutaneous transluminal angioplasty and appropriate multidisciplinary wound care.
METHODS: Totally, 45 consecutive patients (50 limbs) were enrolled and then divided into two groups according to the healing of ulcers. The endpoints were ulcer healing and major adverse events including amputation, mortality, and cardiac or cerebral morbidities, during a six- month follow-up period.
RESULTS: During six months follow-up, major amputation was performed for four of 50 limbs (8.0%). A total of nine (20%) patients died and the leading cause was cardiac death (13.3 %). Also, stroke and non-fatal myocardial infarction occurred in three (6.7 %) and one (2.2 %) of the patients, respectively. Among the 29 (59.2 %) healed wounds, 22 (44.9 %) were completely closed. The patients with nonhealing wounds had a higher rate of dialysis (40% vs. 0 %, P-value <0.001) and more ulcers with stage of D3 according to the Texas Wound Classification (60% vs. 31 %, P-value=0.016). Other demographic, clinical, ulcer characteristics and procedural characteristics such as number and level of the treated lesions did not differ significantly between the two groups.
ONCLUSION: Based on our findings, it seems that along with current usual therapeutic routines which focus on wound healing and limb salvage, more attention should be paid to simultaneous diagnostic assessments and treatment of cardiovascular disease in this group of patients during short-term follow- up.

 
Keyword(s): DIABETIC FOOT, LIMB SALVAGE, PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY
 
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