PMID- 35786131
OWN - NLM
STAT- MEDLINE
DCOM- 20231110
LR  - 20231129
IS  - 1545-1550 (Electronic)
IS  - 1526-6028 (Linking)
VI  - 30
IP  - 6
DP  - 2023 Dec
TI  - Clinical Implications of Diabetic Peripheral Neuropathy in Primary Infrapopliteal 
      Angioplasty Approach for Neuro-Ischemic Foot Wounds.
PG  - 920-930
LID - 10.1177/15266028221106312 [doi]
AB  - BACKGROUND: To assess the clinical effects of diabetic peripheral neuropathy 
      (DPN) in patients with chronic limb-threatening ischemia (CLTI) treated by 
      primary infrapopliteal angioplasty for neuro-ischemic Rutherford 5, foot wounds. 
      MATERIALS AND METHODS: Over a 10-year period (2009-2019), a series of 304 
      diabetic ischemic limbs adding or not evincible neuropathic affectation were 
      treated by primary infrapopliteal angioplasty and their files were 
      retrospectively reviewed. Mean length of treated arterial lesions was 6.1 cm 
      (range 1-22 cm). Inferior limb vibration perception threshold diagnostic was 
      performed for comparing and scoring detectable DPN in all studied diabetic 
      patients (classed from 0 to 10 points). There were 19% limbs with normal (0-1 
      points) perception (group 1), 55% others with "mild" and "moderate" (2-6 points) 
      neuropathic impairment (group 2), and 26% limbs showing "severe" (7-10 points) 
      DPN (group 3). RESULTS: Primary infrapopliteal angioplasty succeeded in 89% cases 
      in group 1, in 82% in group 2, and in 68% of limbs in group 3. This latest group 
      assembled the heaviest neuropathic affectation and arterial calcifications and 
      proved the lowest clinical benefit at 36 months: 35% (95% confidence interval 
      [CI]=22% to 48%) of primary patency, 36% (95% CI=22% to 50%) wound healing, and 
      54% (95% CI=39% to 69%) limb preservation rates. A comparison between groups 1 vs 
      3 and 2 vs 3 of primary patency (p=0.014 and p=0.043), tissue healing (p=0.049 
      and p=0.01), and limb salvage (p=0.006 and p=0.023) proved significant, yet 
      without statistical weight for group 1 vs 2 (p>0.05). Overall survival was not 
      significantly affected between groups (p=0.34). CONCLUSION: The presence of 
      severe DPN may jeopardize the results of infrapopliteal angioplasty in terms of 
      patency, tissue cicatrization, and limb preservation, yet without significance on 
      survival of these patients. When present, DPN requires appropriate stratification 
      as specific indicator in CLTI treatment.
FAU - Alexandrescu, Vlad Adrian
AU  - Alexandrescu VA
AUID- ORCID: 0000-0002-9181-7993
AD  - Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, 
      Marche-en-Famenne, Belgium.
FAU - Van Overmeire, Lionel
AU  - Van Overmeire L
AD  - Department of Nephrology and Internal Medicine, Princess Paola Hospital, Vivalia, 
      Marche-en-Famenne, Belgium.
FAU - Makrygiannis, Georgios
AU  - Makrygiannis G
AD  - Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, 
      Marche-en-Famenne, Belgium.
FAU - Azdad, Khalid
AU  - Azdad K
AD  - Department of Radiology, Princess Paola Hospital, Vivalia, Marche-en-Famenne, 
      Belgium.
FAU - Popitiu, Mircea
AU  - Popitiu M
AUID- ORCID: 0000-0002-0227-457X
AD  - Department of Vascular Surgery and Reconstructive Microsurgery, Victor Babes 
      University of Medicine and Pharmacy, Timisoara, Romania.
FAU - Paquet, Severine
AU  - Paquet S
AUID- ORCID: 0000-0002-3060-2155
AD  - Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, 
      Marche-en-Famenne, Belgium.
FAU - Poppe, Laura
AU  - Poppe L
AD  - Department of Thoracic and Vascular Surgery, Princess Paola Hospital, Vivalia, 
      Marche-en-Famenne, Belgium.
FAU - Nodit, Mihaela
AU  - Nodit M
AD  - Department of Geriatric Care and Internal Medicine, Princess Paola Hospital, 
      Vivalia, Marche-en-Famenne, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20220702
PL  - United States
TA  - J Endovasc Ther
JT  - Journal of endovascular therapy : an official journal of the International 
      Society of Endovascular Specialists
JID - 100896915
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - *Diabetic Neuropathies
MH  - Treatment Outcome
MH  - Angioplasty/adverse effects
MH  - Ischemia/diagnostic imaging/therapy
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Chronic Limb-Threatening Ischemia
MH  - Limb Salvage
MH  - *Angioplasty, Balloon
MH  - Vascular Patency
MH  - Risk Factors
MH  - *Diabetes Mellitus
OTO - NOTNLM
OT  - angioplasty
OT  - arterial calcifications
OT  - below-the-knee
OT  - chronic limb-threatening ischemia
OT  - chronic total occlusion
OT  - critical limb ischemia
OT  - diabetic foot
OT  - diabetic neuropathy
OT  - limb salvage
OT  - wound healing
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2022/07/06 06:00
MHDA- 2023/11/10 06:45
CRDT- 2022/07/05 13:10
PHST- 2023/11/10 06:45 [medline]
PHST- 2022/07/06 06:00 [pubmed]
PHST- 2022/07/05 13:10 [entrez]
AID - 10.1177/15266028221106312 [doi]
PST - ppublish
SO  - J Endovasc Ther. 2023 Dec;30(6):920-930. doi: 10.1177/15266028221106312. Epub 
      2022 Jul 2.