Author/Authors :
Kassaian, Ebrahim tehran university of medical sciences tums - Tehran Heart Center - Interventional Cardiology Department, تهران, ايران , Mohajeri-Tehrani, Mohammad-reza tehran university of medical sciences tums - Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Center, تهران, ايران , Dehghan-Nayyeri, Alireza tehran university of medical sciences tums - Tehran Heart Center - Interventional Cardiology Department, تهران, ايران , Saroukhani, Sepideh tehran university of medical sciences tums - Tehran Heart Center - Clinical Research Department, تهران, ايران , Annabestani, Zohreh tehran university of medical sciences tums - Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Center, تهران, ايران , Alidoosti, Mohammad tehran university of medical sciences tums - Tehran Heart Center - Interventional Cardiology Department, تهران, ايران , Shirani, Shapour tehran university of medical sciences tums - Tehran Heart Center - Radiology Department, تهران, ايران , Shojaei-Fard, Abolfazl tehran university of medical sciences tums - Shariati Hospital - Vascular Surgery Department, تهران, ايران , Molavi, Behnam tehran university of medical sciences tums - Sina Hospital, Trauma Research Center - Vascular Surgery Department, تهران, ايران , Poorhosseini, Hamid Reza tehran university of medical sciences tums - Tehran Heart Center - Interventional Cardiology Department, تهران, ايران , Salarifar, Mojtaba tehran university of medical sciences tums - Tehran Heart Center - Interventional cardiology Department, تهران, ايران , Aboee-Rad, Maryam tehran university of medical sciences tums - Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Center, تهران, ايران , Pashang, Mina tehran university of medical sciences tums - Tehran Heart Center - Clinical Research Department, تهران, ايران , Larijani, Bagher tehran university of medical sciences tums - Endocrinology and Metabolism Clinical Sciences Institute, Endocrinology and Metabolism Research Center, تهران, ايران
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 ofthe treated lesions did not differ significantly between the two groups. Conclusion: 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.
