Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease.

IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Jornal Vascular Brasileiro Pub Date : 2023-01-01 DOI:10.1590/1677-5449.202000531

Giovanni Ortale Trainotti, Jamil Victor Mariúba, Matheus Bertanha, Marcone Lima Sobreira, Ricardo de Alvarenga Yoshida, Rodrigo Gibin Jaldin, Paula Angeleli Bueno de Camargo, Winston Bonetti Yoshida

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引用次数: 1

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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糖尿病与非糖尿病外周动脉病变患者血管造影改变的比较研究。

背景:糖尿病患者发生外周动脉疾病(PAD)的风险是非糖尿病患者的5-15倍，很少有研究比较糖尿病患者与非糖尿病患者动脉病变的危险因素、分布和严重程度。目的:比较糖尿病和非糖尿病晚期PAD患者的血管造影变化及其与危险因素的相关性。方法:采用TASC II和Bollinger等血管造影评分对连续接受下肢动脉造影的PAD患者进行回顾性横断面研究(Rutherford 3-6)。排除标准为上肢血管造影，图像不清，实验室检查结果不完整，既往动脉手术。统计分析采用卡方检验，离散数据采用Fisher检验，连续数据采用Student t检验(显著性水平:p < 0.05)。结果:153例患者，平均年龄67岁，女性50.9%，糖尿病患者58.2%。共有91例(59%)患者有营养损害(Rutherford 5或6)，62例(41%)患者有静息性疼痛或局限性跛行(Rutherford 3和4)。糖尿病患者中，81.7%患有高血压，29.4%从未吸烟，14%有急性心肌梗死史。根据Bollinger等人的评分，糖尿病患者腘下动脉受影响更大，尤其是胫骨前动脉(p = 0.005)，而非糖尿病患者股浅动脉受影响更大(p = 0.008)。根据TASC II，最严重的股腘段血管造影改变发生在非糖尿病患者(p = 0.019)。结论:糖尿病患者最常见的病变部位为腘下区，非糖尿病患者最常见的病变部位为股动脉。

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来源期刊

Jornal Vascular Brasileiro Medicine-Cardiology and Cardiovascular Medicine

CiteScore

1.20

自引率

0.00%

发文量

审稿时长

20 weeks

期刊介绍： The Jornal Vascular Brasileiro is editated and published quaterly to select and disseminate high-quality scientific contents concerning original research, novel surgical and diagnostic techniques, and clinical observations in the field of vascular surgery, angiology, and endovascular surgery. Its abbreviated title is J. Vasc. Bras., which should be used in bibliographies, footnotes and bibliographical references and strips.