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Successful Revascularization has a Significant Impact on Limb Salvage Rate and Wound Healing for Patients with Diabetic Foot Ulcers: Single-Centre Retrospective Analysis with a Multidisciplinary Approach

  • Clinical Investigation
  • Arterial Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Analyze the impact of endovascular revascularization on major amputation rates and wound healing for patients with diabetic foot ulcers (DFUs).

Materials and Methods

Single-center retrospective study from 2014–2018 including 314 patients with DFUs submitted to endovascular revascularizations. Group A—patients with a successful endovascular revascularization (n = 285; 90.8%); Group B—patients submitted to a failed attempt of endovascular revascularization (n = 29; 9.2%). Baseline data were not significantly different between the 2 groups (p > 0.05). Both groups were compared regarding: major amputation rates; wound healing, mortality and adverse events. Survival and regression analyses were used.

Results

Mean follow-up time was 734.1 ± 610.2 days. Major amputation rates were 3.9% versus 24.1% (p < 0.0001) and complete wound healing was 53.7% versus 20.7% (p < 0.0001) for patients from Group A versus Group B, respectively. Major adverse events were registered in 2 patients (one from each group); minor adverse events included 10 patients from Group A and 2 patients from Group B (p = 0.3654). Major amputation rates were: 3.9% versus 27.5% at 1 year; 4.6% versus 27.5% at 2–5 years for Group A versus Group B, respectively (p < 0.0001). Survival rates were: 87.8% at 1 year; 84.4% at 2 years; and 77.9% at 5 years with no significant differences between groups. Predictors for major amputation included failed revascularization (p < 0.0001), older age (p = 0.0394), prior stroke (0.0018), dialysis (0.0476). Predictors for mortality included older age (p < 0.0001) and coronary artery disease (p = 0.0388).

Conclusion

Endovascular revascularization for patients with DFUs is safe and has a significant impact on limb salvage and wound healing.

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Acknowledgements

These data were submitted as a manuscript and accepted for CIRSE 2020 in September.

Funding

No grants or funding were obtained for this specific manuscript.

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Authors and Affiliations

  1. Centro Hospitalar Universitário de Lisboa Central (CHULC), 1069-166, Lisbon, Portugal

    António Proença Caetano & Inês Conde Vasco

  2. Interventional Radiology Unit, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central (CHULC), 1069-166, Lisbon, Portugal

    António Proença Caetano, Inês Conde Vasco, Filipe Veloso Gomes, Nuno Vasco Costa, José Hugo Luz & Tiago Bilhim

  3. Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal

    António Proença Caetano, Filipe Veloso Gomes, Nuno Vasco Costa, José Hugo Luz & Tiago Bilhim

  4. SBD Analytics, Bekkevoort, Belgium

    Erik Spaepen

  5. Diabetic Foot Unit, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central (CHULC), 1069-166, Lisbon, Portugal

    Ana Formiga

  6. Head Interventional Radiology Unit, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central (CHULC), 1069-166, Lisbon, Portugal

    Élia Coimbra

  7. Head of Diabetic Foot Unit, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central (CHULC), 1069-166, Lisbon, Portugal

    José Neves

Authors
  1. António Proença Caetano
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  2. Inês Conde Vasco
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  7. Ana Formiga
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  10. Tiago Bilhim
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Corresponding author

Correspondence to Tiago Bilhim.

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Conflict of interest

Tiago Bilhim is a paid consultant for Merit Medical and has received speaker fees for Philips Medical, Cook Medical, Terumo and is a stock holder for EmbolX.

Nuno Vasco Costa is a paid consultant for Merit Medical.

Filipe Veloso Gomes is a paid consultant for Terumo.

Ethical Approval

Institutional review board approval was waived to perform this retrospective analysis.

Informed Consent

Informed Consent was obtained from all patients.

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Consent for Publication was obtained.

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Caetano, A.P., Conde Vasco, I., Veloso Gomes, F. et al. Successful Revascularization has a Significant Impact on Limb Salvage Rate and Wound Healing for Patients with Diabetic Foot Ulcers: Single-Centre Retrospective Analysis with a Multidisciplinary Approach. Cardiovasc Intervent Radiol 43, 1449–1459 (2020). https://doi.org/10.1007/s00270-020-02604-4

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  • DOI: https://doi.org/10.1007/s00270-020-02604-4

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