Tibial angioplasty in diabetics

Abstract

BackgroundDiabetics are pron e to develop serious complications such as nephropathy, retinal detachment, and others, and among such complications lies the devastating serious complication of diabetic foot, whether ulceration or diabetic foot infections up till gangrene. This could be attributed to either one or all of the following etiological factors: peripheral vascular disease, peripheral neuropathy, and/or infection owing to impaired immunity.Patients and methodsWe enrolled 88 diabetic ischemic patients with tibial artery disease confirmed by Duplex. Their mean age was 67 years (54 males and 34 females). Patients were subjected to ipsilateral antegrade transluminal or subintimal tibial angioplasty. The procedure and its complication and alternatives were explained to the patients, and a written informed consent was signed.ResultsA total of 54 males and 34 females, with mean age of 67 years, were recruited. Patients were categorized as Rutherford 3 (three patients), 4 (seven patients), 5 (54 patients), and 6 (23 patients). In two patients, failed crossing of the lesion resulted in major amputation. Minor amputation rate after successful revascularization was 48.2% of patients and healed completely. One case was complicated by pseudoaneurysm. No mortalities were encountered in our series. Follow-up by Duplex assessment revealed a rate of freedom from occlusion of 68% and secondary patency of 80% at 1-year follow-up.ConclusionSuccessful tibial angioplasty could result in limb salvage and reduction of limb amputation rate in diabetics with otherwise controlled risk factors.