Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia : Prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003

Objective. To evaluate the effectiveness of peripheral angioplasty (PTA) as the first-choice revascularisation procedure in diabetic patients with critical limb ischemia (CLI). Design. Prospective study. Methods. PTA was employed as first choice revascularisation in a consecutive series of diabetic patients hospitalized for CLI between January 1999 and December 2003. Results. PTA was success I performed in 993 patients. Seventeen (1.7 %) major amputations were carried out. One death and 33 non-fatal complications were observed. Mean follow-up was 26 +/- 15 months. Clinical restenosis was observed in 87 patients. The 5 years primary patency was 88 %, 95 % CI 86-91 %. During follow-up 119 (12.0 %) patients died at a rate Of 6.7 % per year. Conclusions. PTA as the first choice revascularisation procedure is feasible, safe and effective for limb salvage in a high percentage of diabetic patients. Clinical restenosis was an infrequent event and PTA could successfully be repeated in most cases.