Objective: To retrospectively explore the status of primary patency after subintimal angioplasty (SIA) and identify the risk factors affecting for primary patency of occlusive lesions in femoral arteries after SIA in patients with diabeticses mellitus.
Methods: From January 2009 to May 2011, 43 diabetics patients with 43 occlusive femoral arteries were successfully underwent subintimal angioplasty successfully with or without stenting.Recurrent stenosis was defined as an arterial diameter reduction of over 50%. And arterial occlusion was confirmed by an absence of color or power signal in the arterial lumen measured on color Doppler. The Kaplan-Meier method was employed to determine the primary patency. A multivariate analysis was performed with Cox's proportional hazard regression model to determine the independent factors for effects on primary patency.
Results: A total of 17 morphologic abnormalities occurred during a median follow-up period of 21 (14-32) months. The median follow time of the successful 43 patients was 21 months (from 14 to 32 month). Minor complications occurred in 4 patents. There was no early mortality. A total of 17 morphologic abnormalities occurred during follow-up. The cumulative primary patency at 6, 12, 12 and 24 months were (86 ± 5)%, (75% ± 7)% and (43 ± 12)% respectively. Primary patency was affected negatively by the number of occlusive run-off vessels (B = -4.417, SX- = 1.627, P = 0.007) and the severity degree according to the Inter-society consensus for the management of peripheral arterial disease (TASC II) classification (B = -2.502, SX- = 0.955, P = 0.009), and positively by the a history of smoking (B = 3.115, SX- = 1.523, P = 0.041).
Conclusions: Subintimal angioplasty is a less invasive procedure with a lower rate of morbidity and adequate cceptable patency. And the number of occlusive run-off vessels, lesion typing degree of severity according to the TASC II classification negatively and smoking positively have significant influence effects on the primary patency in diabetics patients.