Meloni Marco, Izzo Valentina, Del Giudice Costantino, Pampana Enrico, Da Ros Valerio, Vainieri Erika, Giurato Laura, Ruotolo Valeria, Gandini Roberto, Uccioli Luigi

1. Peripheral arterial disease in
diabetic patients who need a new
treatment after first endovascular
approach:
differences between patients on
dialysis and not
Dr. Marco MeloniDr. Marco Meloni
DepartmentDepartment ofof InternalInternal MedicineMedicine
UniversityUniversity ofof TorTor VergataVergata
RomeRome
24° Conference of the
European Wound Management Association
Madrid, 14-16 May 2014

2. Materials and methods
• 456 patients (292 M, 164 W): ESRD
(ESRD +) (n=60)
ESRD (ESRD -) (n=396)
• Diabetes, peripheral arterial disease
complicated by critical limb
ischaemia and foot lesions
• Aim:
- Analyses of patients who needed
Re-PTA
- Outcomes after Re-PTA
- Arterial disease pattern in dialyzed
patients and not

3. Re-pta and radiological
outcomes
0
10
20
30
40
50
60
70
80
90
100
Re-PTA Rad. Outc.
ESRD +
ESRD -
* 0.043
* 0.01

4. Arterial disease
pattern before the
first PTA
0
10
20
30
40
50
60
70
ATK BTK ABK
ESRD +
ESRD -
X2=0.57
ATK: above the knee; BTK: below the knee ABK: above-below the knee
Arterial pattern
observed before
the re-PTA
0
10
20
30
40
50
60
RD UD WD
ESRD +
ESRD -
RD: recurrence disease; UD: untreated disease; WD: worsening disease
X2=0.14

5. Conclusions
• Our data confirm that PTA failure is higher
in diabetic patients under dialysis
compared to them without
• The worse outcome of PTA may be
related neither to the pattern of the
affected vessels nor to recurrence or
worsening of vascular diseases.
• ESRD patients have more vessels
calcification that can hamper the
endovascular treatment with a technical
poor success
• In patient on dialysis treatment the arterial
disease is more distal and also collateral
vessels can be involved
• Uremia could be negatively influence the
healing wound process