Peripheral arterial disease in diabetic patients who need a newtreatment after first endovascular

approach: differences between patients on

dialysis and not

Dr. Marco MeloniDr. Marco Meloni

DepartmentDepartment ofof InternalInternal MedicineMedicine

UniversityUniversity ofof TorTor VergataVergata

RomeRome

24° Conference of the

European Wound Management Association

Madrid, 14-16 May 2014

Materials and methods

• 456 patients (292 M, 164 W): ESRD (ESRD +) (n=60)ESRD (ESRD -) (n=396)

• Diabetes, peripheral arterial diseasecomplicated by critical limbischaemia and foot lesions

• Aim:- Analyses of patients who needed

Re-PTA- Outcomes after Re-PTA- Arterial disease pattern in dialyzed

patients and not

Re-pta and radiologicaloutcomes

0102030405060708090

100

Re-PTA Rad. Outc.

ESRD +ESRD -

* 0.043

* 0.01

Arterial disease pattern before the

first PTA

0

10

20

30

40

50

60

70

ATK BTK ABK

ESRD +ESRD -

X2=0.57

ATK: above the knee; BTK: below the knee ABK: above-below the knee

Arterial pattern observed before

the re-PTA

0

10

20

30

40

50

60

RD UD WD

ESRD +ESRD -

RD: recurrence disease; UD: untreated disease; WD: worsening disease

X2=0.14

Conclusions• Our data confirm that PTA failure is higher

in diabetic patients under dialysis compared to them without

• The worse outcome of PTA may be related neither to the pattern of the affected vessels nor to recurrence or worsening of vascular diseases.

• ESRD patients have more vesselscalcification that can hamper the endovascular treatment with a technicalpoor success

• In patient on dialysis treatment the arterialdisease is more distal and also collateralvessels can be involved

• Uremia could be negatively influence the healing wound process