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Diabetes Obesity and Metabolism
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Long‐term efficacy of autologous cell therapy, repeated PTA and conservative treatment in people with diabetes and chronic limb‐threatening ischaemia

Authors: Dubsky, Michal; Sojakova, Dominika; Husakova, Jitka; Nemcova, Andrea; Fejfarova, Vladimira; Jarosikova, Radka; Frelichova, Veronika; +2 Authors

Long‐term efficacy of autologous cell therapy, repeated PTA and conservative treatment in people with diabetes and chronic limb‐threatening ischaemia

Abstract

Abstract Aims Data about long‐term clinical outcomes of revascularization procedures, especially for autologous cell therapy (ACT), in diabetic patients with chronic limb‐threatening ischaemia (CLTI) are lacking. The aim of our study was to compare the mortality and amputation rates in patients with diabetic foot ulcers (DFU) and CLTI treated by ACT with patients treated by repeated percutaneous transluminal angioplasty (re‐PTA) and those treated conservatively. Materials and Methods One‐hundred and thirty patients with DFU and CLTI (defined as transcutaneous oxygen pressure—TcPO 2 <30 mmHg after unsuccessful standard revascularization) treated in our foot clinic over 9 years were enrolled in the study. Forty‐five patients were treated by ACT, 43 patients underwent re‐PTA, and 42 patients were treated conservatively and formed the control group. Overall survival, amputation‐free survival (AFS) and major amputation rate were assessed over a 7‐year follow‐up period. Results Baseline demographic characteristics and comorbidities were similar between groups. However, patients in ACT and control groups had significantly worse baseline angiograms in accordance with Graziani and GLASS (infrapopliteal region) classifications than the re‐PTA group (both p < 0.001), but there were no differences in baseline values of TcPO 2 between groups. AFS in the ACT and re‐PTA groups were significantly longer compared to control (both p < 0.001). The rate of major amputation was significantly lower in both active groups (both p < 0.001). The re‐PTA group showed significantly longer overall survival compared to the control group ( p < 0.001), but there was no significant difference between ACT and control groups ( p = 0.063) and ACT and re‐PTA groups ( p = 0.081) in this parameter. Conclusions Our study showed significantly longer AFS and lower major amputation rates in patients treated by ACT and re‐PTA in contrast to patients treated conservatively. Overall survival was significantly longer only in the re‐PTA group. ACT was shown to be effective in long‐term limb salvage in people with no‐option CLTI.

Keywords

Male, Chronic Limb-Threatening Ischemia, Cell- and Tissue-Based Therapy, effectiveness, cellular research, Conservative Treatment, Transplantation, Autologous, Amputation, Surgical, Ischemia, Humans, Aged, chronic limb-threatening ischemia, treatment, diabetes, Angioplasty, diabetes complications, clinical trial, Middle Aged, Limb Salvage, Diabetic Foot, Treatment Outcome, Original Article, Female, cell therapy

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green
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