Below Knee Angioplasty in Diabetic Patients: Predictors of Major Adverse Clinical Outcomes

AHMED A. TAHA, M.D., MOHAMED A.A. KASHKOUSH, M.Sc.;; AHMED G. FOUAD, M.D., AHMED S. MOSTAFA, M.D.;

doi:10.21608/mjcu.2020.125482

Below Knee Angioplasty in Diabetic Patients: Predictors of Major Adverse Clinical Outcomes

Document Type : Original Article

Authors

The Department of Vascular Surgery, National Institute of Diabetes* and The Department of General & Vascular Surgery, Faculty of Medicine, Cairo University**, Egypt

10.21608/mjcu.2020.125482

Abstract

Abstract Background: Tibial vessel disease (stenoses or occlusions) has a huge variety of outcomes either technical or clinical, which has an impact on the health authorities. Aim of Study: To locate clinical outcome predictors fol-lowing Plain Old Balloon Angioplasty (POBA) in diabetic patients with below knee atherosclerotic lesions causing Chronic Limb Threatening Ischemia (CLTI). Patients and Methods: Over one year, 67 patients (CLTI 100%) underwent infragenicular angioplasty. Our main interest was Major Adverse Clinical Outcome (MACO) of thelimb operated upon at follow-up which was adressed as clinical failure, need for subsequent endovascular or surgical revas-cularization or amputation. Results: Amputation free survival was seen in 88% with CLTI. Sound healing of wounds was achieved in 76% of cases with a mean value of healing timeof 10.7 months. Significant predictors of MACO were technical failure (p-value 0.002) and occlusive lesions (p-value 0.019). Freedom of MACO was achieved in 76.1%. Conclusions: Infragenicular angioplasty is a feasible therapeutic option in diabetic population. Type ofthe lesions in addition to smoking may be predictors of adverse outcome.

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