This document discusses outcomes after percutaneous transluminal angioplasty (PTA) in diabetic patients with end-stage renal disease (ESRD) complicated by critical limb ischaemia and foot lesions. The study found that at 12 months, limb salvage rates were 60% for ESRD patients and 78% for non-ESRD patients, with significantly lower mortality in the ESRD group. The findings suggest that PTA is an effective first-line treatment for peripheral artery disease in diabetic patients with ESRD.

1. KidneyKidney--footfoot syndromesyndrome::
outcomesoutcomes afterafter PTA inPTA in
end stageend stage renalrenal diseasedisease
diabeticdiabetic patientspatients
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

2. MaterialsMaterials andand methodsmethods
456456 patientspatients (292 M, 164 W):(292 M, 164 W):
ESRD (ESRD (ESRDESRD +) (n=60)+) (n=60)
ESRD (ESRD (ESRDESRD --) (n=396)) (n=396)
DiabetesDiabetes,, peripheralperipheral arterialarterial
diseasedisease complicatedcomplicated byby criticalcritical
limblimb ischaemiaischaemia andand footfoot lesionslesions
OutcomesOutcomes (at 12(at 12 monthsmonths):):
-- LimbLimb salvagesalvage
-- MajorMajor amputationamputation
-- DeathDeath

3. ResultsResults
ESRD +
Limb Salvage 60%
Amputation 18%
Death 22%
ESRD -
Limb Salvage 78%
Amputation 11%
Death 11%

4. ResultsResults
0
10
20
30
40
50
60
70
80
ESRD - ESRD +
Alive without major
amputation
Alive with major
amputation
Death
ESRD: End Stage Renal Disease
* 0.0175

5. ConclusionsConclusions
InIn ourour studystudy PTAPTA allowsallows aa
limbslimbs salvagesalvage nono differentdifferent fromfrom
resultsresults obtainedobtained withwith byby--passpass
butbut inin unselectedunselected patientspatients andand
withwith aa reducedreduced 11--yearyear mortalitymortality
(22% vs 38%)(22% vs 38%)
OurOur data, after comparativedata, after comparative
evaluationevaluation,, supportsupport PTAPTA asas firstfirst
approachapproach forfor treatment oftreatment of
PAD inPAD in patientspatients withwith diabetesdiabetes
and ESRDand ESRD