A Study on The Prevalence And Risk Factors Associated with Peripheral Vascular Disease In Type2 Diabetes Mellitus

Category: Diabetes Introduction/Purpose: Despite the presence of several studies examining the conversion from transmetatarsal amputation (TMA) to a more proximal amputation, few studies identified the possible predictors of failure. The objective of this study is to examine the rate of conversion of transmetatarsal amputation to below or above knee amputation, and to identify the risk factors for conversion. Methods: A retrospective cohort study was performed examining 71 transmetatarsal amputations performed by a single group of foot and ankle subspecialists within a single specialty group between October 1 2005 and August 25 2015. Demographic information and comorbidities were recorded, as were complications, readmission rate, and rate of conversion to a more proximal amputation. Results: Of the 71 patients who underwent transmetatarsal amputation during the study period, 74.7% progressed to a revision amputation or more proximal amputation at a mean of 9.7 months, but a median of only 3.2 months. 87.3% progressed to below knee amputation, 9.9% underwent revision transmetatarsal amputation, and 2.8% received an above knee amputation. Of the patients who progressed to more proximal amputation, 88.2% had diabetes mellitus, 72.4% had a pre-operative ulceration, and 81.7% had peripheral neuropathy. Only 52.7% had diagnosed peripheral vascular disease, 38.1% had a history of renal disease, and 35% were smokers. Conclusion: Transmetatarsal amputation has an extremely high short-term reamputation rate with the vast progressing to a below knee amputation. Comorbidities such as diabetes mellitus, neuropathy, and history of ulceration are often found in these patients, while renal and peripheral vascular disease as well as tobacco abuse are not necessarily present. This high rate of reamputation may bring into question the efficacy of performing transmetatarsal amputation as opposed to a more proximal amputation as a definitive procedure when lower extremity amputation is required.

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Risk Factors of Peripheral Vascular Disease in Diabetes Mellitus in Abbottabad, Pakistan: A Cross-Sectional Study

Cureus ◽

10.7759/cureus.17556 ◽

2021 ◽

Author(s):

Abdul Majid Khan ◽

Petras Lohana ◽

Priyanka Anvekar ◽

Syed Hassan Mustafa ◽

Ramesh Kumar ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Peripheral Vascular ◽

Cross Sectional

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Tests for Platelet Changes, Acute Phase Reactants and Serum Lipids in Diabetes mellitus and Peripheral Vascular Disease

Thrombosis and Haemostasis ◽

10.1055/s-0038-1657283 ◽

1982 ◽

Vol 48 (03) ◽

pp. 289-293 ◽

Cited By ~ 17

Author(s):

B A van Oost ◽

B F E Veldhuyzen ◽

H C van Houwelingen ◽

A P M Timmermans ◽

J J Sixma

Keyword(s):

Diabetes Mellitus ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Acute Phase ◽

Serum Lipids ◽

Diabetic Patients ◽

Peripheral Vascular ◽

Acute Phase Reactants ◽

Control Subjects ◽

And Control

SummaryPlatelets tests, acute phase reactants and serum lipids were measured in patients with diabetes mellitus and patients with peripheral vascular disease. Patients frequently had abnormal platelet tests and significantly increased acute phase reactants and serum lipids, compared to young healthy control subjects. These differences were compared with multidiscriminant analysis. Patients could be separated in part from the control subjects with variables derived from the measurement of acute phase proteins and serum lipids. Platelet test results improved the separation between diabetics and control subjects, but not between patients with peripheral vascular disease and control subjects. Diabetic patients with severe retinopathy frequently had evidence of platelet activation. They also had increased acute phase reactants and serum lipids compared to diabetics with absent or nonproliferative retinopathy. In patients with peripheral vascular disease, only the fibrinogen concentration was related to the degree of vessel damage by arteriography.

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Correlation of Ankle Brachial Index with Peripheral Vascular Disease in Type 2 Diabetes Mellitus

10.7176/jmpb/57-02 ◽

2019 ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Ankle Brachial Index ◽

Peripheral Vascular

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Diabetes Mellitus and Peripheral Vascular Disease

Diabetes and Peripheral Vascular Disease ◽

10.1007/978-1-62703-158-5_3 ◽

2012 ◽

pp. 27-38

Author(s):

Matthew J. Freeby

Keyword(s):

Diabetes Mellitus ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Peripheral Vascular

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Comparative Histopathology of Radial Artery Versus Internal Thoracic Artery and Risk Factors for Development of Intimal Hyperplasia and Atherosclerosis

Circulation ◽

10.1161/circ.100.suppl_2.ii-139 ◽

1999 ◽

Vol 100 (suppl_2) ◽

Author(s):

Permyos Ruengsakulrach ◽

Roger Sinclair ◽

Masashi Komeda ◽

Jai Raman ◽

Ian Gordon ◽

...

Keyword(s):

Risk Factors ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Radial Artery ◽

Morphometric Analysis ◽

Intimal Hyperplasia ◽

Internal Thoracic Artery ◽

Peripheral Vascular ◽

Luminal Narrowing ◽

Intimal Thickness

Background —In this study, we examined the comparative histopathology, morphometry, and risk factors for the development of intimal hyperplasia and atherosclerosis in the radial artery (RA) and the internal thoracic artery (ITA). Methods and Results —Paired specimens of RAs and ITAs, obtained from 150 patients who underwent CABG, were evaluated with histopathology; 110 pairs of arteries were suitable for morphometric analysis. The severity of disease was evaluated on the basis of percentage of luminal narrowing, intimal thickness index, and intima-to-media ratio. Risk factors were determined with stepwise linear regression. Intimal hyperplasia was seen in 141 RAs (94%) and 103 ITAs (69%) ( P <0.001). Atherosclerosis was seen in 5% of RAs and 0.7% of ITAs ( P =0.04). Medial calcification was found only in RAs (20 of 150, 13.3%) ( P <0.001). Morphometric analysis showed that compared with ITAs, RAs had a significantly higher intimal area, medial area, percentage of luminal narrowing, intimal thickness index, and intima-to-media ratio (all P <0.001) Factors found to be significant ( P <0.05) predictors of the 3 severity indices of intimal hyperplasia, including atherosclerosis, in RAs were peripheral vascular disease, smoking, age, and diabetes. Risk factors for intimal hyperplasia in ITAs were age and smoking. Conclusions —The RA is more likely to have atherosclerosis, intimal hyperplasia, and medial calcification than the ITA. Morphometric analysis indices showed marked differences between the RA and the ITA. Care should be taken when selecting the RA as a conduit in CABG, particularly in patients who are elderly, diabetic, smoke, or have peripheral vascular disease.

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