The Results of Endovascular and Open Revascularization Methods in Patients with Peripheral Arterial Disease on the Background of Diabetes Mellitus

Nikolay Lukianchikov  ¹, Anastasia Artemova ², Petr Puzdryak  ², Michael Ivanov  ²

¹ I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation, Moscow, Russia; ² Department of General Surgery of North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia;

Date, time and location: 2018.05.26 08:30, Exhibition area, 1st Floor. Zone – A

Abstract

The aim of this study was to evaluate the results of surgical interventions in case of PAD in patients with diabetes.

Materials and methods: The work is based on the observations of 67 patients with DM-2, who underwent reconstruction of the arterial channel due to PAD. Patients who underwent endovascular interventions (angioplasty/stenting) composed the main group. 15 patients with traditional (open) bypass interventions composed the control group. The presence of comorbid pathology, duration of hospitalization, partial oxygen pressure in the tissues before and after the operation, presence of complications, lethality within 30 days after the operation were analyzed. 

Results: Among the patients of the main group, 34 patients underwent balloon angioplasty, 21-balloon angioplasty with stenting. Technical success was achieved in 100% of cases.  The implementation of EV in patients with a severe course of comorbidities was considered preferable. The duration of hospitalization in the control group was 1.5 times higher than in the main group (p<0.05). Endovascular interventions were characterized by better dynamics of trophic changes (improvement was noted in 100% of patients), compared with open methods (noted in 68.9% of cases, p<0.05). The evaluation of oxygenation of tissues at the foot level after 5 to 7 days after the operative intervention also showed a better dynamics after endovascular correction methods (p<0.05). The total number of so-called "major" complications (thrombosis, bleeding, infectious complications) in the group of open operations was significantly higher (4 v/s 2, p<0.05). The frequency of major complications in the groups was associated with the duration of the operative interventions (82±46 min v/s 216±108 min) in the EV and OS groups, respectively (p<0.05).

Conclusions: the results of endovasal correction methods in patients with DM-2 in early terms are preferable to the results of traditional interventions.