Safety and Effectiveness of Endovascular Therapy for the Treatment of Peripheral Artery Disease in Patients with and without Diabetes Mellitus

Abstract

This study investigated the distribution of risk factors, lesion characteristics and endovascular revascularization (EVR) strategies in patients with peripheral arterial disease (PAD) with vs without diabetes mellitus (DM). Data were collected within the RECcording COurses of vasculaR Diseases (RECCORD) registry. Demographic data, lesion localization (iliac vs femoropopliteal vs below-the-knee (BTK)) and lesion complexity score (LCS) based on number of affected segments, and lesion length (< 10 vs 10–20 vs > 20 cm), EVR strategies and peri-procedural complications were analysed in 786 patients with and 1337 without diabetes mellitus. Patients with diabetes mellitus were older (71.6 ± 9.6 vs 69.4 ± 10.5 years, P < .001) and had higher LCS and more often BTK lesions ( P < .05 for all). Lesions were treated less frequently with stents (48.7 vs 59.6%, P < .001) in patients with diabetes mellitus, whereas a non-significant trend was noticed for higher DCB treatment rates (48.3 vs 44.4%, P = .07). Post-interventional ankle-brachial index (ABI) increase was similar (from .77 ± .28 to .92 ± .25 with diabetes mellitus and from .74 ± .21 to .90 ± .20 without diabetes mellitus, P < .001 for both). Peri-/post-procedural complications were low in both groups (4.6%). Patients with diabetes mellitus, who undergo endovascular revascularization are older, have more comorbidities and higher target lesion complexity. However, treatment success rates are similar and complication rates are low.

Expansion of Bypass as a Revascularization Option for Patients With Chronic Limb-Threatening Ischemia

“…8 Furthermore, it has been reported that patients with DM are less frequently treated with stents and have higher target lesion complexity. 9 A recent meta-analysis (31 studies; 58,813 patients) reported that the presence of DM is strongly associated with lower primary (relative risk [RR] = .74; 95% CI: .58–.95; P = .001) and secondary patency rates (RR = .80; 95% CI: .67–.96; P = .009) in patients offered an endovascular intervention or a surgical procedure for PAD. 10 In this meta-analysis, 12 studies only included patients treated with open surgery, 13 studies only included patients treated with an endovascular intervention, and 6 studies included patients treated by both open surgery and endovascular interventions.…”