Outcome of percutaneous transluminal angioplasty in diabetic patients with critical limb ischaemia.

Objective: We investigated the clinical outcome of percutaneous transluminal angioplasty (PTA) which has not been fully established in diabetic patients with critical limb Ischaemia (CLI) compared with non-diabetics. Design and patients: A total of 73 limbs of 52 patients (50 limbs of 34 diabetic patients and 23 limbs of 18 non-diabetics) who underwent PTA for CLI (Rutherford-Becker category 4, 5 or 6) were enrolled. Rates of amputation and restenosis, and ankle brachial index (ABI), were assessed before and after PTA during a 36-month followup period. Results: Diabetic patients had a higher rate of major amputations after PTA (10 vs. 0 %, P < 0.05); however, total amputation (12.0 vs. 8.7 %, P = 0.62) and restenosis rates (4.0 vs. 8.7 %, P = 0.38) were not significantly different compared with nondiabetic patients. ABI at 3 months after PTA was significantly improved in both diabetic and nondiabetic patients (0.70 +/- 0.20 vs. 0.93 +/- 0.19, P < 0.01 in diabetic patients; 0.69 +/- 0.25 vs. 0.92 +/- 0.17, P < 0.01 in non-diabetics). Improved ABI was maintained for 36 months in both groups and did not show a signifi cant diff erence (0.88 +/- 0.21 vs. 0.89 +/- 0.20, P = 0.89). Conclusion: Our results, showing that the outcome of PTA in diabetic patients is not inferior to that in non-diabetics, suggest the potential benefi t of primary PTA, instead of bypass surgery, for CLI in diabetic patients who are at high risk of perioperative complications.