Effect of diabetes on the prognosis, serum inflammatory factors, and quality of life of patients with lower extremity arteriosclerosis obliterans after vascular intervention: a retrospective comparative cohort study

Ann Palliat Med. 2022 Aug;11(8):2720-2729. doi: 10.21037/apm-22-827.


Background: Lower extremity arteriosclerosis obliterans (LEASO) is a chronic progressive disease with clinical manifestations such as intermittent claudication, resting pain, and even ulceration or necrosis of the lower extremities caused by insufficient blood supply to the diseased limbs. This study aimed to evaluate the effect of diabetes on the prognosis of LEASO patients after the percutaneous transluminal angioplasty (PTA) treatment.

Methods: The clinical data of LEASO patients who received PTA treatment in the Blood Hernia Minimally Invasive Surgery Ward of Xuzhou Central Hospital from January 2017 to December 2021 were retrospectively analyzed. The patients were divided into a diabetic group and a non-diabetic group. The general data, lesion location, technical and clinical success rates, changes in the ankle-brachial index (ABI) and serum inflammatory factors, perioperative complications, resting pain relief rate, amputation rate, and quality of life of the two groups were compared.

Results: A total of 223 LEASO patients (256 limbs) were included, including 78 patients with diabetes (91 limbs) and 145 patients without diabetes (165 limbs). Compared with the non-diabetic group, the proportion of lesions in the superior genicular artery was lower, and that in the inferior genicular artery was higher in the diabetic group (P<0.05). Compared with the diabetic group, the levels of serum inflammatory factors in the non-diabetic group were significantly lower than those in the diabetic group, while the clinical success rate was markedly higher (P<0.05). Moreover, the body pain, general health, and mental health scores of the non-diabetic group were considerably higher than those of the diabetic group patients. Logistic regression analysis showed that the odds ratio (OR) values of Rutherford stage, diabetes and C-reactive protein (CRP) level were 20.124, 44.893 and 14.523 respectively, P<0.05, which were independent factors affecting clinical success.

Conclusions: PTA to treat diabetic patients with LEASO can achieve short-term efficacy similar to that of non-diabetic patients. However, the long-term clinical success rate and quality of life of diabetes patients are still inferior to those of non-diabetic patients. Standardized postoperative anti-inflammatory treatment and blood glucose control are crucial for long-term efficacy.

Keywords: Lower extremity arteriosclerosis obliterans (LEASO); diabetes mellitus (DM); prognosis; quality of life; vascular intervention.

MeSH terms

  • Arteriosclerosis Obliterans* / complications
  • Arteriosclerosis Obliterans* / surgery
  • Cohort Studies
  • Diabetes Mellitus*
  • Humans
  • Lower Extremity
  • Pain
  • Prognosis
  • Quality of Life
  • Retrospective Studies
  • Treatment Outcome