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

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Butt, TalhaLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital (author)

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

Article/chapterEnglish2019

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2018-11-22
SAGE Publications,2019

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LIBRIS-ID:oai:lup.lub.lu.se:5053dfda-c8c0-48c7-a662-95b9d64f3fa8
https://lup.lub.lu.se/record/5053dfda-c8c0-48c7-a662-95b9d64f3fa8URI
https://doi.org/10.1177/1538574418813746DOI

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Language:English
Summary in:English

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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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Lilja, ErikaLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)er8107li (author)
Örneholm, HedvigLund University,Lunds universitet,Ortopedi,Forskargrupper vid Lunds universitet,Orthopedics,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-hgs (author)
Apelqvist, JanLund University,Lunds universitet,Translationell muskelforskning,Forskargrupper vid Lunds universitet,Translational Muscle Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)endo-jap (author)
Gottsäter, AndersLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-ago (author)
Eneroth, MagnusLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)ort-men (author)
Acosta, StefanLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)uro-sac (author)
Vaskulära sjukdomar - kliniska studierForskargrupper vid Lunds universitet (creator_code:org_t)

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In:Vascular and Endovascular Surgery: SAGE Publications53:2, s. 118-1251938-91161538-5744

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By the author/editor: Butt, Talha; Lilja, Erika; Örneholm, Hedvig; Apelqvist, Jan; Gottsäter, Ander ...; Eneroth, Magnus; show more...; Acosta, Stefan; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Endocrinology an ...

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