Diyabetik ve non-diyabetik hasta gruplarında kronik ekstremite tehdit eden iskemide endovasküler tedavi etkinliğinin değerlendirilmesi

Öz

Amaç: Periferik arter hastalıkları, aterosklerozun neden olduğu günümüzde giderek yaygınlaşan hastalıklardır. Çalışmamızda Periferik Transluminal Anjiyoplasti (PTA) uygulanan kronik ekstremite tehdit eden bacak iskemisi olan, diyabetik ve non-diyabetik hasta gruplarının, klinik sonuçlarını değerlendirmeyi amaçladık. Yöntemler: Haziran 2013 - Mart 2020 tarihleri arasında kronik ekstremite tehdit eden bacak iskemisi (Rutherford sınıf 4 ve üzeri) nedeniyle alt ekstremite arteriyel lezyonlarına (darlık / tıkanıklık) perkütan transluminal anjiyoplasti (PTA) işlemi uygulanan 150 hasta (84 diyabetik / 66 non-diyabetik) çalışmaya dahil edilmiştir. Bulgular: Altı aylık primer açıklık oranları diyabetik ve diyabetik olmayan grupta sırasıyla %86,5 ve %93,3 idi. 12 aylık primer açıklık oranları %73,0 ve %73,3 iken; 12 aylık sekonder açıklık oranları ise %66,7 ve %77,8 idi. Açıklık oranları açısından gruplar arasında farklılık tespit edilmedi. Diyabetik hasta grubunda majör ampütasyon (%16,7-%6,1; P=0,003) ve toplam amputasyon oranları (%34,6-%22,8; P=0,004) istatistiksel olarak anlamlı düzeylerde daha yüksekti. Sonuç: Endovasküler tedavi sonrası ekstremite tehdit eden kronik bacak iskemisi olan diyabetik ve diyabetik olmayan hasta gruplarında açıklık ve amputasyon oranları değerlendirildiğinde, her iki grupta da başarılı klinik sonuçlar bildirilmiştir. Güncel sonuçlarımız, endovasküler tedavinin ekstremite tehdit eden iskemide her iki hasta grubunda da etkili bir şekilde kullanılabileceğini göstermektedir.

Anahtar Kelimeler

• Ekstremite tehdit eden iskemi
• Endovasküler girişim
• Diabetes mellitus

Assessment of the efficacy of endovascular treatment in chronic limb-threatening ischemia in diabetic and non-diabetic patients

Öz

Aim: Peripheral artery diseases are a very common manifestation of atherosclerosis. We assessed the clinical outcomes of diabetic versus non-diabetic patients with chronic limb-threatening leg ischemia who underwent Peripheral Transluminal Angioplasty (PTA). Methods: The patients (84 diabetic/66 non-diabetic) who underwent percutaneous transluminal angioplasty (PTA) in the lower extremity arterial lesions (stenosis/occlusion) because of chronic limb-threatening leg ischemia (Rutherford class 4 and above) between June 2013 and March 2020 were included in the study. Results: Six-month primary patency rates were 86.5% and 93.3% in the diabetic and non-diabetic group, respectively. The 12-month primary patency rates were 73.0% and 73.3%; and 12-month secondary patency rates were 66.7% and 77.8%. No differences were detected between the groups in terms of patency rates. Major amputation and total amputation rates were higher at statistically significant levels in the diabetic patient group (%16.7% vs. 6.1%; P=0.003) (34.6% vs. 22.8%); P=0.004) Conclusion: When patency and amputation rates are evaluated in diabetic and non-diabetic patient groups with limb-threatening chronic leg ischemia after endovascular treatment, good clinical results were reported in these two groups. Current results suggest that endovascular treatment can be used safely and effectively in both patient groups.

Anahtar Kelimeler

• limb-threatening ischemia
• endovascular intervention
• diabetes mellitus

Kaynakça

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