• 1

    Criqui MH: Peripheral arterial disease: epidemiological aspects. .Vasc Med 6: (suppl 1):3. ,2001. .

  • 2

    Investigators BARI: Influence of diabetes on 5-year mortality and morbidity in a randomized trial comparing CABG and PTCA in patients with multivessel disease: the Bypass Angioplasty Revascularization Investigation (BARI). .Circulation 96::1761. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Weintraub WS, Stein B, Kosinski A, et al: Outcome of coronary bypass surgery versus coronary angioplasty in diabetic patients with multivessel coronary artery disease. .J Am Coll Cardiol 31::10. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Hoffman SN, TenBrook JA, Wolf MP, et al: A meta-analysis of randomized controlled trials comparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty: one- to eight-year outcomes. .J Am Coll Cardiol 41::1293. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    TASC Working Group. Management of peripheral arterial disease (PAD): Trans-Atlantic Inter-Society Consensus (TASC). .J Vasc Surg 31::S1. ,2000. .

  • 6

    Trans-Atlantic Inter-Society Consensus for the management of PAD. .J Vasc Surg 43: (suppl):S1. ,2007. .

  • 7

    Brass EP, Anthony R, Dormandy J, et al: Parenteral therapy with lipo-ecraprost, a lipid-based formulation of a PGE1 analog, does not alter six-month outcomes in patients with critical leg ischemia. .J Vasc Surg 43::752. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Bradbury AW, Adam DJ, Bell J, et al: The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. .J Vasc Surg 51::5S. ,2010. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Taylor SM, Cull DL, Kalbaugh CA, et al: Comparison of interventional outcomes according to preoperative indication: a single center analysis of 2,240 limb revascularizations. .J Am Coll Surg 208::770. ,2009. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Cheng SWK, Ting AWC, Ho P: Angioplasty and primary stenting of high-grade, long-segment superficial femoral artery disease: is it worthwhile?. Ann Vasc Surg 17::430. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Surowiec SM, Davies MG, Eberly SW, et al: Percutaneous angioplasty and stenting of the superficial femoral artery. .J Vasc Surg 41::269. ,2005. .

  • 12

    Johnston KW: Femoral and popliteal arteries: reanalysis of results of balloon angioplasty. .Radiology 183::767. ,1992. .

  • 13

    Clark TWI, Groffsky JL, Soulen MC: Predictors of long-term patency after femoropopliteal angioplasty: results from the STAR Registry. .J Vasc Interv Radiol 12::923. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Jamsen TS, Manninen HI, Tulla HE, et al: Infrainguinal revascularization because of claudication: total long-term outcome of endovascular and surgical treatment. .J Vasc Surg 37::808. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Ihnat DM, Duong ST, Taylor ZC, et al: Contemporary outcomes after superficial femoral artery angioplasty and stenting: the influence of TASC classification and runoff score. .J Vasc Surg 47::967. ,2008. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Mitchell DC, Murray A, Wood RF, et al: Laser-assisted angioplasty for arterial occlusion of the lower limb: initial results and follow-up. .Br J Surg 79::81. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Zeller T, Frank U, Burgelin K, et al: Initial clinical experience with percutaneous atherectomy in the infragenicular arteries. .J Endovasc Ther 10::987. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Vraux H, Hammer F, Verheist R, et al: Subintimal angioplasty of tibial occlusions in the treatment of critical limb ischemia: mid-term results. .Eur J Vasc Endovasc Surg 20::441. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Vraux H, Bertoncello N: Subintimal angioplasty of tibial vessel occlusions in critical limb ischemia: a good opportunity?. Eur J Vasc Endovasc Surg 32::663. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Tartari S, Zattoni L, Rolma G, et al: Subintimal angioplasty of infrapopliteal artery occlusions in the treatment of critical limb ischemia: short-term results. .Radiol Med 108::265. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Giles KA, Pomposelli FB, Hamdan AD, et al: Infrapopliteal angioplasty for critical limb ischemia: relation of TransAtlantic Intersociety Consensus class to outcome in 176 limbs. .J Vasc Surg 48::128. ,2008. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Schillinger M, Sabeti S, Loewe C, et al: Balloon angioplasty versus implantation of Nitinol stents in the superficial femoral artery. .N Engl J Med 354::1879. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Lazaris AM, Tsiamis AC, Fishwick G, et al: Clinical outcome of primary infrainguinal subintimal angioplasty in diabetic patients with critical lower limb ischemia. .J Endovasc Ther 11::447. ,2004. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Pomposelli FB, Kansal N, Hamdan AD, et al: A decade of experience with dorsalis pedis artery bypass: analysis of outcome in more than 1000 cases. .J Vasc Surg 37::307. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Conte MS, Bandyk DF, Clowes AW, et al: Results of PREVENT III: a multicenter, randomized trial of edifoligide for the prevention of vein graft failure in lower extremity bypass surgery. .J Vasc Surg 43::742. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    DeRubertis BG, Faries PL, McKinsey JF, et al: Shifting paradigms in the treatment of lower extremity vascular disease: a report of 1000 percutaneous interventions. .Ann Surg 246::415. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Dick F, Diehm N, Galimanis A, et al: Surgical or endovascular revascularization in patients with critical limb ischemia: influence of diabetes mellitus on clinical outcome. .J Vasc Surg 45::751. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Rutherford RB, Baker JD, Ernst C, et al: Recommended standards for reports dealing with lower extremity ischemia: revised version. .J Vasc Surg 26::517. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Kougias P, Chen A, Cagiannos C, et al: Subintimal placement of covered stent versus subintimal balloon angioplasty in the treatment of long-segment superficial femoral artery occlusion. .Am J Surg 198::645. ,2009. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Lugmayr HF, Holzer H, Kastner M, et al: Treatment of complex arteriosclerotic lesions with nitinol stents in the superficial femoral and popliteal arteries: a midterm follow-up. .Radiology 222::37. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Sabeti S, Mlekusch W, Amighi J, et al: Primary patency of long-segment self-expanding nitinol stents in the femoropopliteal arteries. .J Endovasc Ther 12::6. ,2005. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Dearing DD, Patel KR, Compoginis JM, et al: Primary stenting of the superficial femoral and popliteal artery. .J Vasc Surg 50::542. ,2009. .

  • 33

    Baril DT, Marone LK, Kim J, et al: Outcomes of endovascular interventions for TASC II B and C femoropopliteal lesions. .J Vasc Surg 48::627. ,2008. .

  • 34

    Bakken AM, Palchik E, Hart JP, et al: Impact of diabetes mellitus on outcomes of superficial femoral artery endoluminal interventions. .J Vasc Surg 46::946. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Sadek M, Ellozy SH, Turnbull IC, et al: Improved outcomes are associated with multilevel endovascular intervention involving the tibial vessels compared with isolated tibial intervention. .J Vasc Surg 49::638. ,2009. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Gray BH, Grant AA, Kalbaugh CA, et al: The impact of isolated tibial disease on outcomes in the critical limb ischemic population. .Ann Vasc Surg 24::349. ,2010. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Schanzer A, Mega J, Meadows J, et al: Risk stratification in critical limb ischemia: derivation and validation of a model to predict amputation-free survival using multi-center surgical outcomes data. .J Vasc Surg 48::1464. ,2008. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Conrad MF, Cambria RP, Stone DH, et al: Intermediate results of percutaneous endovascular therapy of femoropopliteal occlusive disease: a contemporary series. .J Vasc Surg 44::762. ,2006. .

    • PubMed
    • Search Google Scholar
    • Export Citation

Current Assessment of Endovascular Therapy for Infrainguinal Arterial Occlusive Disease in Patients with Diabetes

Daniel M. Ihnat Department of Vascular and Endovascular Surgery, University of Arizona Health Sciences Center, Tucson, AZ.

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Joseph L. Mills Sr Department of Vascular and Endovascular Surgery, University of Arizona Health Sciences Center, Tucson, AZ.

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Endovascular therapy has increasingly become the initial clinical option for the treatment of lower-extremity peripheral arterial occlusive disease not only for patients with claudication but also for those with critical limb ischemia. Despite this major clinical practice paradigm shift, the outcomes of endovascular therapy for peripheral arterial disease are difficult to evaluate and compare with established surgical benchmarks because of the lack of prospective randomized trials, incomplete characterization of indications for intervention, mixing of arterial segments and extent of disease treated, the multiplicity of endovascular therapy techniques used, the exclusion of early treatment failures, crossover to open bypass during follow-up, and the frequent lack of intermediate and long-term patency and limb salvage rates in life-table format. These data limitations are especially problematic when one tries to assess the outcomes of endovascular therapy in patients with diabetes. The purpose of the present article is to succinctly review and objectively analyze available data regarding the results of endovascular therapy in patients with diabetes. (J Am Podiatr Med Assoc 100(5): 424–428, 2010)

Corresponding author: Joseph L. Mills, Sr, MD, Professor of Surgery, Chief of Vascular and Endovascular Surgery, University of Arizona Health Sciences Center, 1501 N Campbell Ave, PO Box 245072, Tucson, AZ 85724. (E-mail: jmills@u.arizona.edu)
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