Rombout Kruse1, Floris B. Poelmann1, Michel Reijnen3, Robert Lind1, Frans L. Moll2, Wilbert M. Fritschy1
1Isala Clinics, Zwolle, Netherlands; 2University Medical Centre Utrecht, Utrecht, Netherlands; 3Rijnstate Hospital, Arnhem, Netherlands.
OBJECTIVES: Diabetic patients form an important challenge in treating occlusive disease of the SFA. In this study, we have evaluated the results of 327 patients treated in two hospitals in the Netherlands over a 10-year period. These patients were treated with an e-PTFE nitinol self-expanding endograft in the SFA/popliteal region for occlusive disease. The aim of this study is to compare the results of patients with diabetes (DM), with patients that didn't have diabetes (non-DM).
METHODS: Male-to-female ratio was 73.7% vs. 26.3%. Mean age during surgery was 69 years. All patients included had clinical symptoms of intermittent claudication or critical limb ischaemia (CLI). SFA lesions of both groups of patients were scored according to the Trans-Atlantic Inter Society Consensus (TASC II). Follow-up was done after 3, 6 and 12 months, and every year thereafter. 36.7% of patients had DM (n=120). Our objective was to assess primary and secondary 2-year patency in both DM patients and in non-DM patients and compared the 2. Statistical analysis was done forming Kaplan Meier survival curves to describe patency during follow-up. The two groups were compared using Log Rank (Mantel-Cox) analysis. Follow-up included duplex ultrasonography and ankle brachial indices as well as physical examination.
RESULTS: No statistical differences were found between the two groups with respect to age and TASC classification. TASC II classification in DM group was TASC A/B/C/D: 25/39/25/31 and in the non-DM group: 51/54/37/65, p-value 0,436 (NS). Two-year primary and secondary patency was 60.8% and 90% in the DM group (n=120), and 65.2%and 82.6% in the non-DM group (n=207). Log Rank (Mantel-Cox) analysis of the two Kaplan Meier curves showed p-values of 0,442 and 0,069 (both NS).
CONCLUSIONS: Two-year primary and secondary patency rates of DM patients were equal to that of non-DM patients. The 2-year secondary patency of 90% in the DM group could only be achieved with a follow-up program and subsequent intervention when needed.
AUTHOR DISCLOSURES: W. M. Fritschy: Nothing to disclose; R. Kruse: Nothing to disclose; R. Lind: Nothing to disclose; F. L. Moll: Best Doctors, Honorarium; F. B. Poelmann: Nothing to disclose; M. Reijnen: Nothing to disclose.
Posted April 2013