Influence of diabetes mellitus on the results of providing assistance in critical lower limb ischemia

Introduction. The elimination of critical ischemia in patients with diabetes mellitus requires a delicate approach due to the high risk of complications. The purpose of this study is to analyze the results of revascularization in patients with critical ischemia associated with type 2 diabetes mellitus. Materials and methods. The study involved 135 patients who underwent reconstructive interventions for peripheral arterial disease. Of these, 48 patients suffered from diabetes mellitus, and in 87 patients no disorders of carbohydrate metabolism were registered. The results of surgical interventions were prospectively assessed during the first 30 days after surgery and retrospectively analyzed. Endpoints: primary — reconstructionrelated complications; secondary — major amputations. Adverse events assessed included bleeding, surgicalsite infection, myocardial infarction, stroke, and thrombosis. Results and discussion. Patients with diabetes are more likely to experience adverse effects (52.1 % vs 40.2 %, respectively). In addition, they have more severe postoperative complications. A major role is played by impaired collateral circulation in patients with diabetes mellitus, as well as the presence of concomitant pathologies. Conclusion. At the stage of critical ischemia, the number of dangerous complications after reconstructive surgery increases in people with diabetes mellitus. Against the background of critical ischemia in diabetes mellitus and without it, it is necessary to choose the best option for reconstructive care, taking into account the Archi index, in order to reduce the invasiveness of surgical intervention.

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