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Continuous intrafemoral artery infusion of urokinase improves diabetic foot ulcers healing and decreases cardiovascular events in a long-term follow-up study

Authors :
Min Liu
Ling Yue
Yangyang Cheng
Jing Dong
Lin Xiang
Jiayue Tong
Junxia Zhang
Shuguang Li
Jinling Xu
Guangping Zhu
Hujun Ren
Guangda Xiang
Source :
BMJ Open Diabetes Research & Care, Vol 12, Iss 1 (2024)
Publication Year :
2024
Publisher :
BMJ Publishing Group, 2024.

Abstract

Introduction Diabetic foot ulcer (DFU) is a disabling complication of diabetes mellitus. Here, we attempted to assess whether long-term intrafemoral artery infusion of low-dose urokinase therapy improved DFUs and decreased cardiovascular events in patients with DFUs.Research design and methods This trial was a single-center, randomized, parallel study. A total of 195 patients with DFU were randomized to continuous intrafemoral thrombolysis or conventional therapy groups. The continuous intrafemoral thrombolysis group received continuous intrafemoral urokinase injection for 7 days, and conventional therapy just received wound debridement and dressing change. Then, a follow-up of average 6.5 years was performed.Results Compared with conventional therapy, at the first 1 month of intervention stage, the ulcers achieved a significant improvement in continuous intrafemoral thrombolysis group including a complete closure (72.4% vs 17.5%), an improved ulcer (27.6% vs 25.8%), unchanged or impaired ulcer (0% vs 56.7%). During the 6.5-year follow-up, for the primary outcome of ulcer closure rate, continuous intrafemoral thrombolysis therapy obtained a better complete healing rate (HR 3.42 (95% CI 2.35 to 4.98, p

Details

Language :
English
ISSN :
20524897
Volume :
12
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMJ Open Diabetes Research & Care
Publication Type :
Academic Journal
Accession number :
edsdoj.b24013f81ab14735b806c580c3a5033e
Document Type :
article
Full Text :
https://doi.org/10.1136/bmjdrc-2023-003414