angiographic features of atherosclerotic superficial femoral artery disease in diabetics and...

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Angiographic Features Angiographic Features of Atherosclerotic of Atherosclerotic Superficial Femoral Superficial Femoral Artery Disease in Artery Disease in Diabetics and Non- Diabetics and Non- diabetics Presenting diabetics Presenting with Claudication with Claudication Atif Mohammad, MD Research Fellow VA North Texas Health Care System UT Southwestern Medical Center Dallas,TX On behalf of the investigators:

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Page 1: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

Angiographic Features of Angiographic Features of Atherosclerotic Atherosclerotic

Superficial Femoral Superficial Femoral Artery Disease in Artery Disease in

Diabetics and Non-Diabetics and Non-diabetics Presenting diabetics Presenting

with Claudicationwith Claudication

Atif Mohammad, MDResearch Fellow

VA North Texas Health Care System

UT Southwestern Medical Center

Dallas,TX

On behalf of the investigators:

Page 2: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

INVESTIGATORSINVESTIGATORS

Atif Mohammad, MD*†

Avantika Banerjee*

Omar Hadidi, MD†

Gene Pershwitz, MD*

Mirza Baig, MD*†

Emmanouil S. Brilakis, MD, PhD*†

*VA North Texas Health Care System, Dallas, TX; †University of Texas Southwestern Medical Center, Dallas, TX; Acknowledgements: Dallas VA Research Corporation

Page 3: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

BACKGROUND & METHODBACKGROUND & METHOD

Though clinical outcomes following percutaneous revascularization of superficial femoral artery (SFA) varies between diabetics (DM) and non-diabetics, angiographic differences of their SFA disease has never been systemically analyzed

We conducted blinded angiographic analysis of peripheral angiograms in 117 consecutive patients (79 DM and 38 non-DM) between January 2009 - January 2011, presenting to Veterans Affairs Haelth Care System (Veterans Integrated Service Network or VISN 17) with Rutherford category 3 claudication

Page 4: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

METHOD: ANGIOGRAPHIC METHOD: ANGIOGRAPHIC ANALYSIS ANALYSIS

Page 5: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

BOLLINGER SCOREBOLLINGER SCORE

Page 6: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

RESULTS: Mean Bollinger RESULTS: Mean Bollinger ScoresScores

p=0.03

Non-DM DM

Page 7: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

RESULTS:RESULTS:

SFA: superficial femoral artery

Page 8: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

RESULTS: Angiographic Distribution RESULTS: Angiographic Distribution of SFA in Diabetics & Non-Diabeticsof SFA in Diabetics & Non-Diabetics

n=78

n=39

SFA: superficial femoral artery

Page 9: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

RESULTS: Lesion Flow & Stenosis Characteristics RESULTS: Lesion Flow & Stenosis Characteristics in Diabetics & Non-Diabeticsin Diabetics & Non-Diabetics

Page 10: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

RESULTS: Lesion Characteristics & RESULTS: Lesion Characteristics & Revascularization in Diabetics & Non-Revascularization in Diabetics & Non-DiabeticsDiabetics

Page 11: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

RESULTS: Procedural RESULTS: Procedural Complications & Outcomes in Complications & Outcomes in Diabetics & Non-DiabeticsDiabetics & Non-Diabetics

Page 12: Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

CONCLUSIONS:CONCLUSIONS:These results indicate the greater

severity of SFA disease in patients with diabetes mellitus, increased need for stenting & lower 12 month patency

Our findings also indicate to the need for dedicated strategies for improving outcomes in diabetics with peripheral arterial disease undergoing endovascular revascularization procedures for life-style limiting claudication

SFA: superficial femoral artery