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Amputation-Free Survival in Patients With Diabetes Mellitus and Peripheral Arterial Disease With Heel Ulcer : Open Versus Endovascular Surgery

Butt, Talha LU ; Lilja, Erika LU ; Örneholm, Hedvig LU ; Apelqvist, Jan LU ; Gottsäter, Anders LU ; Eneroth, Magnus LU and Acosta, Stefan LU (2019) In Vascular and Endovascular Surgery 53(2). p.118-125
Abstract

BACKGROUND:: Heel ulcers in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD) are hard to heal. The aim of the present study was to evaluate the difference in amputation-free survival (AFS) between open and endovascular revascularization in patients with DM, PAD, and heel ulcers.

METHODS:: Retrospective comparative study of results of open versus endovascular surgery in patients with DM, PAD, and heel ulcer presented at the multidisciplinary diabetes foot clinic between 1983 and 2013.

RESULTS:: Patients with heel ulcers were treated with endovascular intervention (n = 97) and open vascular surgery (n = 30). Kaplan-Meier analysis showed that the AFS was higher in patients undergoing open vascular... (More)

BACKGROUND:: Heel ulcers in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD) are hard to heal. The aim of the present study was to evaluate the difference in amputation-free survival (AFS) between open and endovascular revascularization in patients with DM, PAD, and heel ulcers.

METHODS:: Retrospective comparative study of results of open versus endovascular surgery in patients with DM, PAD, and heel ulcer presented at the multidisciplinary diabetes foot clinic between 1983 and 2013.

RESULTS:: Patients with heel ulcers were treated with endovascular intervention (n = 97) and open vascular surgery (n = 30). Kaplan-Meier analysis showed that the AFS was higher in patients undergoing open vascular surgery compared to the endovascular group ( P = .009). Multivariate analysis showed that open vascular surgery versus endovascular therapy (hazard ratio 2.1, 95% confidence interval 1.1-3.9; P = .025) was an independent factor associated with higher AFS. The proportion of patients undergoing endovascular therapy in the former (1983-2000) time period was 47% compared to 89% in the latter (2001-2013) time period ( P < .001).

CONCLUSION:: The AFS was higher after open than endovascular surgery among patients with DM and PAD with heel ulcer. These results suggest that open vascular surgery should be offered more often as opposed to current practice.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Vascular and Endovascular Surgery
volume
53
issue
2
pages
118 - 125
publisher
SAGE Publications Inc.
external identifiers
  • scopus:85059554045
ISSN
1938-9116
DOI
10.1177/1538574418813746
language
English
LU publication?
yes
id
5053dfda-c8c0-48c7-a662-95b9d64f3fa8
date added to LUP
2018-12-06 10:03:49
date last changed
2019-08-23 02:17:00
@article{5053dfda-c8c0-48c7-a662-95b9d64f3fa8,
  abstract     = {<p>BACKGROUND:: Heel ulcers in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD) are hard to heal. The aim of the present study was to evaluate the difference in amputation-free survival (AFS) between open and endovascular revascularization in patients with DM, PAD, and heel ulcers.</p><p>METHODS:: Retrospective comparative study of results of open versus endovascular surgery in patients with DM, PAD, and heel ulcer presented at the multidisciplinary diabetes foot clinic between 1983 and 2013.</p><p>RESULTS:: Patients with heel ulcers were treated with endovascular intervention (n = 97) and open vascular surgery (n = 30). Kaplan-Meier analysis showed that the AFS was higher in patients undergoing open vascular surgery compared to the endovascular group ( P = .009). Multivariate analysis showed that open vascular surgery versus endovascular therapy (hazard ratio 2.1, 95% confidence interval 1.1-3.9; P = .025) was an independent factor associated with higher AFS. The proportion of patients undergoing endovascular therapy in the former (1983-2000) time period was 47% compared to 89% in the latter (2001-2013) time period ( P &lt; .001).</p><p>CONCLUSION:: The AFS was higher after open than endovascular surgery among patients with DM and PAD with heel ulcer. These results suggest that open vascular surgery should be offered more often as opposed to current practice.</p>},
  author       = {Butt, Talha and Lilja, Erika and Örneholm, Hedvig and Apelqvist, Jan and Gottsäter, Anders and Eneroth, Magnus and Acosta, Stefan},
  issn         = {1938-9116},
  language     = {eng},
  number       = {2},
  pages        = {118--125},
  publisher    = {SAGE Publications Inc.},
  series       = {Vascular and Endovascular Surgery},
  title        = {Amputation-Free Survival in Patients With Diabetes Mellitus and Peripheral Arterial Disease With Heel Ulcer : Open Versus Endovascular Surgery},
  url          = {http://dx.doi.org/10.1177/1538574418813746},
  volume       = {53},
  year         = {2019},
}