Impact Of Diabetes Mellitus On Outcomes Of Endovascular Therapy For Patients With Atherosclerosis Obliterans

Objective:To evaluate early outcomes of endovascular therapy for atherosclerosis obliterans(ASO) patients with and without diabetes mellitus(DM),and analyze the influence of DM on outcomes of endovascular therapy.Methods:(1) A cohort of 144 consecutive patients treated with endovascular therapy were analyzed retrospectively, 52 diabetic patients and 92 nondiabetic patients. Each intervention was treated as an independent intervention and analyzed individually.(2) For each patients captured, Clinical characteristics, relative risks, comorbidities, target lesions, technical success rate and perioperative complications of all patients were identified. Ankle brachial index(ABI) was measured pre-intervention and early post-intervention.(3) Clinical success rate, rest pain alleviating rate,amputation rate and survival rate were observed during follow-up time.Results:(1) Compared to nondiabetic group, no significant difference was noticed in clinical characteristics, relative risks, comorbidities and Rutherford classifications of diabetic group(P>0.05).(2) Compared to nondiabetic group, anterior tibial artery and peroneal artery lesions occurred more frequently in diabetic patients(P<0.05), but with a lower lesions rate in popliteal artery(P<0.05).(3) Compared to nondiabetic group, no significant difference was noticed in perioperative complications of diabetic group(P>0.05).(4) There was no significant difference in technical success rate, stent implanted rate, 1-year rest pain alleviating rate, 1-year survival rate and 1-year limb salvage rate between diabetic and non-diabetic groups(P>0.05), but there was annotable decrease in 1-year clinical rate of diabetic group(P<0.05). Both groups were resulted in significant ABI improvement(P<0.05). Amputation rate of nondiabetic group and diabetic group was 4.2% and 16.1% respectively, and amputation rate of below the knee in diabetic group was higher than nondiabetic group(P<0.05).Conclusions:(1) Infrapopliteal artery lesions occurred more frequently in diabetic patients, especially on anterior tibial artery and peroneal artery.(2) Endovascular therapy could be an ideal procedure for atherosclerosis obliterans in diabetic and non-diabetic patients, with a certain short-term efficacy and safty.(3) DM has no evident impact in 1-year survival rate,1-year salvage rate and 1-year rest pain alleviating rate, but has a direct decrease in 1-year clinical rate.