Therapeutic Assessment of Percutaneous Transluminal Angioplasty for the Treatment?of Infrapopliteal Arteriosclerosis Obliterans in Diabetic Patients_West China Medical Journal

Authors：

 GUOYun ¹ , LIUXi-ping ¹ , ZHOUHan ¹ , LIUQing-wen ¹ , WUChun-miao ¹ ,  LIXing ²

1. Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University & the Third People's Hospital of Chengdu, Chengdu, Sichuan 610031, P. R. China;
2. Department of Invasive Technology, the Affiliated Hospital of Guiyang Medical College, Guiyang, Guizhou 550004, P. R. China;

Corresponding?author：

LIXing, Email: lixing111@sina.com

Keywords：

Infrapopliteal arteriosclerosis obliterans; Percutaneous transluminal angioplasty; Diabetes mellitus; Therapeutic effect

DOI：

10.7507/1002-0179.20140666

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Objective To investigate and assess the value and efficiency of percutaneous transluminal angioplasty (PTA) for the treatment of infrapopliteal arteriosclerosis obliterans in diabetic patients. Methods Fifty-one diabetic patients with infrapopliteal arteriosclerosis obliterans undergoing PTA in our department from January 2010 to January 2013 were included in this study. Among them, 43 patients were followed up for 2 years. Based on the Fontaine stage, we analyzed their ankle-brachial index (ABI) before and after surgery. The curative effects were evaluated. Results The PTA success rate and clinical symptoms remission rate in Fontaine stage Ⅱ, Ⅲ, and Ⅳ group was 96.2% (25/26), 83.3% (15/18), and 42.9% (3/7), respectively. The success rate for stage Ⅱ patients was significantly higher than that for stage Ⅲ and stage Ⅳ patients (P<0.05). ABI ranged from 0.60±0.11 before surgery to 0.86±0.09, 0.85±0.08, 0.84±0.07, and 0.83±0.08, 3, 6, 12, and 24 months after surgery respectively. Paired t-test showed the difference was statistically significant (P<0.01). There were 9 cases of recurrence during the follow-up. Conclusion PTA is a safe and effective method for diabetic patients with infrapopliteal arteriosclerosis obliterans, and it can improve the patients' clinical symptoms. We can obtain a satisfactory effect in a short term, but the evaluation of long-term effect needs further follow-up.

Citation： GUOYun, LIUXi-ping, ZHOUHan, LIUQing-wen, WUChun-miao, LIXing. Therapeutic Assessment of Percutaneous Transluminal Angioplasty for the Treatment?of Infrapopliteal Arteriosclerosis Obliterans in Diabetic Patients. West China Medical Journal, 2014, 29(12): 2201-2204. doi: 10.7507/1002-0179.20140666 Copy

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4.	Stoffers HE, Rinkens PE, Kestcr AD, et al. The prevalence of asymptomatic and unrecognized peripheral arterial occlusive disease[J]. Int J Epidemiol, 1996, 25(2):282-290.
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7.	Marso SP, Hiatt WR. Peripheral arterial disease with diabetes[J]. J Am Coll Cardiol, 2006, 47(5):921-929.
8.	Beckman JA. Diabetes and atherosclerosis:epidemiology, pathophysiology, and management[J]. JAMA, 2002, 287(19):2570-2581.
9.	Jude EB, Eleftheriadou I, Tentolouris N. Peripheral arterial disease in diabetes-a review[J]. Diabet Med, 2010, 27(1):4-14.
10.	Muniyappa R, Montagnani M, Koh KK, et al. Cardiovascular actions of insulin[J]. Endocr Rev, 2007, 28(5):463-491.
11.	Marso SP, Hiatt WR. Peripheral arterial disease in patients with diabetes[J]. J Am Coll Cardiol, 2006, 47(5):921-929.
12.	鐘曉衛, 劉西平, 李莎, 等. 動脈腔內支架成形術在糖尿病患者中的臨床應用[J]. 西部醫學, 2010, 22(6):1004-1005.
13.	鐘曉衛, 李莎, 付徐泉, 等. 經皮動脈腔內支架成形術聯合自體富血小板凝膠涂布治療糖尿病足(附5例報告)[J]. 山東醫藥, 2010, 50(14):62-63.
14.	Tamura S, Sniderman KW, Beinart C, et al. Percutaneous transluminal angioplasty of the popliteal artery and its branches[J]. Radiology, 1982, 143(3):645-648.
15.	Adam DJ, Beard JD, Cleveland T, et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL):multicentre, randomised controlled trial[J]. Lancet, 2005, 366(951):1925-1934.
16.	Black JH, Lamuraglia GM, Kwolek CJ, et al. Contemporary results of angioplasty-based infrainguinal percutaneous interventions[J]. J Vasc Surg, 2005, 42(5):932-939.
17.	lsaji T, Takayama T, Endo A, et al. Current status of the medical expenses for the treatment of arteriosclerosis obliterans in Japan[J]. Int Angiol, 2010, 29(Suppl 2):61-68.
18.	Koshikawa M, Ikeda U. Arteriosclerosis obliterans (ASO)[J]. Nihon Rinsho, 2010, 68(5):926-929.
19.	谷涌泉, 張建, 齊立行, 等. 動脈自膨式支架置入治療下肢缺血[J]. 中國微創外科雜志, 2006, 6(11):824-826.

1. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease(TASC Ⅱ)[J]. Eur J Vasc Endovase Surg, 2007, 33(Suppl 1):S1-S75.
2. 陳孝平, 石應康, 段德生. 外科學(七年制)[M]. 北京:人民衛生出版社, 2002:776-777.
3. Faglia E, Clerici G, Clerissi J, et al. When is a technically successful peripheral angioplasty effective in preventing above-the-ankle amputation in diabetic patients with critical limb ischaemia?[J]. Diabet Med, 2007, 24(8):823-829.
4. Stoffers HE, Rinkens PE, Kestcr AD, et al. The prevalence of asymptomatic and unrecognized peripheral arterial occlusive disease[J]. Int J Epidemiol, 1996, 25(2):282-290.
5. Yang WY, Lu JM, Weng JP, et al. Prevalence of diabetes among men and women in China[J]. N Engl J Med, 2010, 362(12):1090-1101.
6. Lee IT, Huang CN, Lee WJ, et al. High total-to-HDL cholesterol ratio predicting deterioration of ankle brachial index in Asian type 2 diabetic subjects[J]. Diabetes Res Clin Pract, 2008, 79(3):419-426.
7. Marso SP, Hiatt WR. Peripheral arterial disease with diabetes[J]. J Am Coll Cardiol, 2006, 47(5):921-929.
8. Beckman JA. Diabetes and atherosclerosis:epidemiology, pathophysiology, and management[J]. JAMA, 2002, 287(19):2570-2581.
9. Jude EB, Eleftheriadou I, Tentolouris N. Peripheral arterial disease in diabetes-a review[J]. Diabet Med, 2010, 27(1):4-14.
10. Muniyappa R, Montagnani M, Koh KK, et al. Cardiovascular actions of insulin[J]. Endocr Rev, 2007, 28(5):463-491.
11. Marso SP, Hiatt WR. Peripheral arterial disease in patients with diabetes[J]. J Am Coll Cardiol, 2006, 47(5):921-929.
12. 鐘曉衛, 劉西平, 李莎, 等. 動脈腔內支架成形術在糖尿病患者中的臨床應用[J]. 西部醫學, 2010, 22(6):1004-1005.
13. 鐘曉衛, 李莎, 付徐泉, 等. 經皮動脈腔內支架成形術聯合自體富血小板凝膠涂布治療糖尿病足(附5例報告)[J]. 山東醫藥, 2010, 50(14):62-63.
14. Tamura S, Sniderman KW, Beinart C, et al. Percutaneous transluminal angioplasty of the popliteal artery and its branches[J]. Radiology, 1982, 143(3):645-648.
15. Adam DJ, Beard JD, Cleveland T, et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL):multicentre, randomised controlled trial[J]. Lancet, 2005, 366(951):1925-1934.
16. Black JH, Lamuraglia GM, Kwolek CJ, et al. Contemporary results of angioplasty-based infrainguinal percutaneous interventions[J]. J Vasc Surg, 2005, 42(5):932-939.
17. lsaji T, Takayama T, Endo A, et al. Current status of the medical expenses for the treatment of arteriosclerosis obliterans in Japan[J]. Int Angiol, 2010, 29(Suppl 2):61-68.
18. Koshikawa M, Ikeda U. Arteriosclerosis obliterans (ASO)[J]. Nihon Rinsho, 2010, 68(5):926-929.
19. 谷涌泉, 張建, 齊立行, 等. 動脈自膨式支架置入治療下肢缺血[J]. 中國微創外科雜志, 2006, 6(11):824-826.

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Therapeutic Assessment of Percutaneous Transluminal Angioplasty for the Treatment?of Infrapopliteal Arteriosclerosis Obliterans in Diabetic Patients

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