Lee Michael S, Rha Seung-Woon, Han Seung Kyu, Choi Byoung Geol, Choi Se Yeon, Ali Jabar, Xu Shaopeng, Ngow Harris Abdullah, Lee Jae Joong, Lee Kwang No, Kim Ji Bak, Lee Sunki, Na Jin Oh, Choi Cheol Ung, Lim Hong Euy, Kim Jin Won, Kim Eung Ju, Park Chang Gyu, Seo Hong Seog, Kong Jeremy, Oh Dong Joo
Cardiovascular Center, Korea University Guro Hospital, 80, Gurodong, Guro-gu, Seoul, 152-703, Korea.
J Invasive Cardiol. 2015 Mar;27(3):167-71.
Peripheral arterial disease (PAD) is associated with poor outcomes. We assessed the clinical outcomes of diabetic versus non-diabetic patients with PAD who underwent peripheral transluminal angioplasty (PTA).
The outcomes of 239 consecutive patients with symptomatic PAD who underwent PTA were analyzed. Restenosis and clinical outcomes were assessed at a follow-up of 2 years.
Diabetic patients had a higher percentage of wound as the initial diagnosis for PTA (72.7% vs. 14.2%; P<.001), chronic kidney disease (26.7% vs. 6.3%; P<.01), need for dialysis (19.3% vs. 3.1%; P<.01), and coronary artery disease (67.6% vs. 50.7%; P=.02). Infrapopliteal PTA was more commonly performed in the diabetic group (70.4% vs. 25.3%; P<.001). Diabetic patients had lower rates of angiographic follow-up at 8 months (38.6% vs. 60.3%; P<.01). Diabetic patients had higher binary restenosis (54.4% vs. 31.5%; P=.02) and had a trend toward a higher incidence of total occlusion (34.0% vs. 19.5%; P=.08). At 2-year follow-up, the amputation rate was higher in the diabetic group (24.4% vs. 1.5%; P<.001) despite PTA.
Diabetic patients more frequently presented with critical limb ischemia compared with non-diabetic patients and had higher rates of restenosis and amputation at 2 years following standard PTA. Improved therapies are needed for this high-risk group of patients.
外周动脉疾病（PAD）与不良预后相关。我们评估了接受外周血管腔内血管成形术（PTA）的糖尿病与非糖尿病PAD患者的临床结局。
分析了239例连续接受PTA的有症状PAD患者的结局。在2年的随访中评估再狭窄情况和临床结局。
糖尿病患者以伤口作为PTA初始诊断的比例更高（72.7%对14.2%；P<0.001），慢性肾脏病发生率更高（26.7%对6.3%；P<0.01），透析需求更高（19.3%对3.1%；P<0.01），冠状动脉疾病发生率更高（67.6%对50.7%；P=0.02）。糖尿病组更常进行腘动脉以下PTA（70.4%对25.3%；P<0.001）。糖尿病患者8个月时血管造影随访率较低（38.6%对60.3%；P<0.01）。糖尿病患者二元再狭窄率更高（54.4%对31.5%；P=0.02），总闭塞发生率有更高的趋势（34.0%对19.5%；P=0.08）。在2年随访时，尽管进行了PTA，但糖尿病组截肢率更高（24.4%对1.5%；P<0.001）。
与非糖尿病患者相比，糖尿病患者更常表现为严重肢体缺血，在标准PTA后2年再狭窄率和截肢率更高。需要为这一高危患者群体改进治疗方法。
