Long Term Effects of Below-the-Knee Angioplasty in Diabetic Patients with Critical Ischemia of Lower Limbs Referred to Sina Hospital During 2010-2011

Despite significant advances in the treatment of diabetic foot ulcers and below-the-knee critical ischemia, there are ongoing efforts to achieve a method with low complication, high success rate and persistence of long-term effects. The aim of the study was to examine the outcome of angioplasty in patients with below-the-knee critical ischemia referred to Hospital. Material and methods. This semi-experimental study conducted on diabetics patients treated with PTA (Percutaneous transluminal angioplasty) with critical ischemia of lower limbs referred to Sina Hospital. After discharge, the patients were followed weekly for the first month and then monthly up to 12 months. The procedure short-term effects were examined through evaluation of wound healing as well as patients' recovery and pain relief, after one month. Given the distribution type, parametric and non-parametric test were used to compare the results before and after treatment. Pearson's correlation coefficient was used to determine the correlation between variables. Results. Twenty four patients participated in this study. The mean ankle-brachial index (ABI) at baseline was 0.55±0.17. A month after angioplasty, the index increased statistically significant to 0.93±0.16. The mean health score expressed by the patients at baseline was 5.48±1.39. A month after angioplasty, it was significantly increased (6.32±1.24). The mean pain score before enrollment was 6.68±2.52 (according to VAS scale). There was a significant decrease over time (3.45±1.13). The overall mean score of all patients at Rutherford Classification was 3.88±0.63 at baseline. During the 1st month and 6th month follow-up, it was changed to Class 0 that was statistically significant in the first month. Conclusions. This study represents the mid-term outcomes of PTA. Although PTA treatment was associated with improved pain scores, satisfaction with health, classification of limb ischemia and diabetic foot ulcers, the effects only remain short-term and mid-term. However, long-term efficacy of PTA needs to be investigated further.