Endovascular Treatment for Critical Limb Ischemia in Type II Diabetes Mellitus Involving Femoropopliteal and Infrapopliteal Segments: Revascularization Strategy

Figures & data

Table 1 Demographic Data and Patients’ Characteristics. Results are Presented as the Mean ± Standard Deviation

Variables	N=90	Group-1 (n=44)	Group-2 (n=46)	P-value
Age (years ± SD)	67.5±12	67±12	68±12	0.444
Gender (n(%))				0.142
Males	65 (72.2%)	36 (55.4%)	29 (44.6%)
Females	25 (27.8%)	8 (32.0%)	17 (68.0%)
Hypertension	61 (67.8%)	33 (54.0%)	28 (46.0%)	0.500
Smoking	34 (37.8%)	16 (47.0%)	18 (53.0%)	0.664
Hyperlipidemia	51 (56.7%)	26 (51.0%)	25 (49.0%)	1.00
Total cholesterol/mmol/L		4.24±1.2	4.65±1.3	0.123
LDL/mmol/L		2.94±1.0	3.18±1.0	0.277
HDL/mmol/L		0.85±0.25	1.92±6.5	0.283
Triglyceride/mmol/L		2.19±1.4	2.26±1.2	0.803
Chronic renal insufficiency	16 (17.8%)	8 (50.0%)	(50.0%)	1.00
Creatinine/mmol/L		125.28±16	126.90±15	0.960
GFR (mL/min/173m)		52.0	50.0	0.961
Ischemic heart disease	31 (34.4%)	15 (48.4%)	16(51.6%)	0825
Ambulation Status
Independent	78 (86.7%)	38 (86.4%)	40 (87.0%)
Dependent	12 (13.3%)	6 (13.6%)	6 (13.0%)
BMI (kg/m^2)		24.98±2.6	24.82±2.4	0.763
HbA1c/%		8.56±2.0	8.42±1.8	0.727
CRP/Int un/L		69.49±54	63.61±58	0.622
ESR/mm/hr		61.64±39	61.87±37	0.978
MPV/fL		9.48±1.0	9.46±1.2	0.921
Rutherford Classification
Category IV	27 (30.0%)	14 (51.9%)	13 (48.1%)	0.91
Category V	63 (70.0%)	31 (49.2%)	32 (50.8%)	0.92
Medications
Single Antiplatelet	75 (83.3%)	37 (49.3%)	38 (50.7%)	0.95
Dual Antiplatelet	25 (27.8%)	12 (48.0%)	13 (52.0%)	0.95
Statin	50 (55.6%)	27 (54.0%)	23 (46.0%)	0.82
WIFI Score		5.60±1.2	5.47±1.4	0.634
WIFI Stage
Low	11 (12.2%)	10 (90.9%)	1 (9.1%)	0.014
Moderate	58 (64.4%)	28 (48.2%)	30 (51.7%)	0.080
High	21 (23.3%)	8 (38.1%)	13 (61.9%)	0.011
GLASS Stage
Low	17 (18.9%)	14 (82.4%)	3 (17.6%)	0.012
Intermediate	56 (62.2%)	26 (46.4%)	30 (53.6%)	0.090
High	17 (18.9%)	6 (35.3%)	11 (64.7%)	0.006
ABI improvement
Pre-Treatment	0.45±0.01	0.40±0.11	0.50±0.01	0.06
Post-Treatment	0.65±0.03	0.59±0.21	0.71±0.03	0.73

Abbreviations: LDH, low-density lipoprotein; HDL, high-density lipoprotein; BMA, body mass index; CRP, c-reactive protein; ESR, erythrocyte sedimentation rate; MPV, mean platelet volume; GFR, glomerular filtration rate; WIFI, wound ischemia foot infection; GLASS, global anatomic staging system; ABI, ankle brachial index.

Table 2 Atherosclerotic Lesions Types, Distribution and Rate of Intervention

Arteries n (%)	Narrowing	Occlusion	Intervention
Superficial Femoral Artery 58 (64.4%)	26(28.9%)	32 (34.4%)	57 (63.0%)
Popliteal Artery 55 (61.0%)	37 (41.0%)	18 (20.0%)	54 (60.0%)
Anterior Tibial Artery 41 (45.6%)	23 (25.6%)	18 (20.0%)	15 (16.0%)
Posterior Tibial Artery 62 (68.8%)	36 (40.0%)	26 (28.9%)	32 (35.6%)
Peroneal Artery 23 (25.6%)	17 (18.9%)	6 (6.7%)	4 (4.4%)

Table 3 Comparison Between Group-I and Group-II

	Number	Major Amputations	Secondary Interventions	Mortality
Group-I	44	17 (38.6%)	25 (56.8%)	10 (22.7%)
Group-II	46	8 (17.4%)	18 (39.1%)	13 (28.3%)
P-value		0.034	0.139	0.632

Figure 1 Comparison of outcomes among the two groups. (A) Major amputation, (B) mortality, and (C) secondary interventions.