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ORIGINAL ARTICLE
Year : 2018  |  Volume : 37  |  Issue : 3  |  Page : 294-303

Predictive value of angiographic characteristics for endovascular revascularization of the ischemic diabetic foot


Vascular Surgery Unit, Department of General Surgery, Menoufia University, Menoufia, Egypt

Correspondence Address:
Abdelmieniem Fareed
Department of General Surgery, Faculty of Medicine, Menoufia University, Shebin ElKom, Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_123_17

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Background Endovascular techniques have undergone major advances with respect to the treatment of infrapopliteal arterial occlusive disease, mainly as a result of development of new devices. Objective The aim was to evaluate the agreement between the angiographic characteristics and the clinical outcomes after endoluminal revascularization in diabetic patients with critical limb ischemia (CLI). Patients and methods During the study, 64 patients were subjected to angioplasty and followed during an average of 12 months. Clinical and procedural data of diabetic patients with CLI were collected. Preprocedural and postprocedural angiographic images were reviewed to classify lower limb arterial involvement according to the Joint Vascular Society Council calf and foot scores classification. Foot lesions were graded according to the University of Texas classification. Clinical results (healing, nonhealing, or major amputation) were compared with baseline clinical data and angiographic results. Results During the study period, 64 percutaneous procedures were performed, with an immediate technical success rate of 89.8%. Preprocedurally, the mean±SD calf and foot scores were 7.8±1.6 and 7.3±2.3, respectively. After the procedure, the mean calf and foot scores were 4.8±2.3 and 5.9±2.6, respectively. The limb salvage rate was 87% and the major amputation rate was 9.4%. Among all the clinical and angiographic variables included in the analysis, only preprocedural and postprocedural foot scores were associated significantly with the clinical outcome (P<0.05). Conclusion Endoluminal revascularization represents a valuable treatment option in diabetic patients with CLI. Preprocedural and postprocedural foot scores represent the most significant angiographic parameters to evaluate treatment success.


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