Trainotti GO, Mariúba JV, Bertanha M, Sobreira ML, Yoshida RDA, Jaldin RG, de Camargo PAB, Yoshida WB. Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease.
J Vasc Bras 2023;
22:e20200053. [PMID:
36794171 PMCID:
PMC9925060 DOI:
10.1590/1677-5449.202000531]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/05/2022] [Indexed: 02/12/2023] Open
Abstract
Background
Diabetics are at 5-15 times greater risk of developing peripheral arterial disease (PAD) and few studies have compared risk factors and distribution and severity of arterial changes in diabetics compared with non-diabetics.
Objectives
To compare angiographic changes between diabetic and non-diabetic patients with advanced PAD and correlate them with risk factors.
Methods
A retrospective cross-sectional study was conducted of consecutive patients undergoing lower limb arteriography for PAD (Rutherford 3-6) using TASC II and Bollinger et al. angiographic scores. Exclusion criteria were upper limb angiographies, unclear images, incomplete laboratory test results, and previous arterial surgeries. Statistical analyses included chi-square tests, Fisher's test for discrete data, and Student's t test for continuous data (significance level: p < 0.05).
Results
We studied 153 patients with a mean age of 67 years, 50.9% female and 58.2% diabetics. A total of 91 patients (59%) had trophic lesions (Rutherford 5 or 6) and 62 (41%) had resting pain or limiting claudication (Rutherford 3 and 4). Among diabetics, 81.7% were hypertensive, 29.4% had never smoked, and 14% had a history of acute myocardial infarction. According to the Bollinger et al. score, infra-popliteal arteries were more affected in diabetics, especially the anterior tibial artery (p = 0.005), while the superficial femoral artery was more affected in non-diabetics (p = 0.008). According to TASC II, the most severe angiographic changes in the femoral-popliteal segment occurred in non-diabetic patients (p = 0.019).
Conclusions
The most frequently affected sectors were the infra-popliteal sectors in diabetics and the femoral sector in non-diabetics.
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