Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal

Ndeye Fatou Sow; Abdoul Aziz Thiaw; Magaye Gaye; Moussa Diagne; Abdou Ahat Mbengue; Amadou Dioulde Diallo; Papa Adama Dieng

doi:doi:10.11648/j.ijcts.20261205.11

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Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal

Ndeye Fatou Sow

, Abdoul Aziz Thiaw^*

, Magaye Gaye, Moussa Diagne, Abdou Ahat Mbengue, Amadou Dioulde Diallo, Papa Adama Dieng

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 12, Issue 5)

Received: 28 July 2026 Accepted: 6 August 2026 Published: 2 September 2026

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Abstract

Background: Distal angioplasty has become a key therapeutic option for diabetic patients presenting with chronic limb-threatening ischemia (CLTI), particularly in settings where infrapopliteal, diffuse, and calcified lesions are predominant. Despite the growing burden of diabetes in sub-Saharan Africa, regional data remain scarce. Methods: This retrospective, single?center study included all diabetic patients who underwent distal angioplasty at Fann Hospital between January 2021 and December 2022. Clinical characteristics, cardiovascular risk factors, imaging findings, procedural techniques, and postoperative outcomes were analyzed. Results: Eighty-six patients were included (mean age 66.3 ± 7.5 years). Most presented with stage IV ischemia (84.88%). Type 2 diabetes was predominant (95.35%), with a mean duration of 14.3 years. CT angiography revealed multivessel distal disease in nearly all cases. Distal angioplasty was performed under local anesthesia in 96.52% of procedures, with antegrade puncture in 98.8%. A 3mm balloon was used in 87.2% of cases, and stenting was required in only one patient. Residual stenosis occurred in 10.47% of procedures and arterial dissection in 9.3%. Primary wound healing was achieved in 60.81% of patients, with a mean healing time of 4 months. Twenty-six amputations were performed (18 minor, 8 major). Overall mortality reached 17.4%, with hypertension significantly associated with death (p = 0.028). Median survival after angioplasty was 36 days. Conclusion: Distal angioplasty is feasible and effective in diabetic patients with severe lower?limb ischemia, even in resource-limited settings. However, high mortality highlights the need for comprehensive cardiovascular management, early PAD detection, and strengthened multidisciplinary care pathways to improve long-term outcomes.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 12, Issue 5)
DOI	10.11648/j.ijcts.20261205.11
Page(s)	113-121
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Distal Angioplasty, Diabetes, Chronic Limb-threatening Ischemia, Peripheral Arterial Disease

1. Introduction

Peripheral arterial disease of the lower limbs (PAD) represents one of the most severe complications of diabetes, characterized by diffuse, distal, and often calcified lesions that predominantly affect the tibial and peroneal arteries

[1, 2]

. In diabetic patients, the progression is frequently silent until an advanced stage, often leading to critical limb ischemia, chronic ulcerations, severe infections, and a high risk of major amputation

[3, 4]

. In low-resource countries, this clinical picture is further aggravated by delayed diagnosis, limited access to vascular investigations, and a high prevalence of cardiovascular risk factors

[5]

Over the past two decades, distal angioplasty has emerged as a preferred revascularization strategy for patients presenting with limb threatening ischemia, particularly when lesions are infrapopliteal and surgical options are limited

[6, 7]

. This minimally invasive approach helps restore tissue perfusion, promote wound healing, and reduce the need for major amputation

[8, 9]

. However, the outcomes of distal angioplasty remain variable across settings, influenced by lesion severity, the patient’s overall condition, the presence of cardiovascular comorbidities, and the expertise of the treating centers

[6, 10]

In sub Saharan Africa, data on distal angioplasty in diabetic patients remain scarce, even though the burden of diabetes and PAD continues to rise

[11, 12]

. Fann Hospital, a referral center in thoracic and cardiovascular surgery, has been performing endovascular procedures for several years in patients with complex lesions, often at a very advanced stage.

In this context, it is essential to document the clinical characteristics, technical modalities, and outcomes of distal angioplasty in our environment.

The objective of this study is to evaluate the outcomes of distal angioplasty in diabetic patients managed in the Department of Thoracic and Cardiovascular Surgery at Fann Hospital, by analyzing their epidemiological profile, lesion severity, technical aspects of revascularization, and postoperative outcomes, particularly regarding wound healing, amputation, and mortality.

2. Materials

2.1. Study Design

This was a single-center, retrospective, descriptive, and analytical study conducted in the Department of Thoracic and Cardiovascular Surgery at Fann Hospital.

The inclusion period extended from January 1, 2021, to December 31, 2022, corresponding to a total duration of 24 months.

2.2. Study Population

Inclusion criteria

All patients meeting the following criteria were included:

1) Known diabetes (type 1 or type 2).

2) Peripheral arterial disease requiring distal angioplasty (lesions located below the knee).

3) Complete medical records including clinical, paraclinical, and operative data.

Non-inclusion criteria

The following were excluded:

1) Patients who underwent non endovascular revascularization.

2) Isolated proximal angioplasties (femoral, iliac).

3) Incomplete medical records.

2.3. Statistical Analysis

Data analysis was performed using the STATA software.

Quantitative variables were expressed as mean ± standard deviation.

Qualitative variables were presented as counts and percentages.

Comparisons were made using the Chi-square test.

A p-value < 0.05 was considered statistically significant.

3. Results

3.1. Epidemiological Data

The study included 86 diabetic patients who underwent distal angioplasty.

The mean age was 66.3 ± 7.5 years, with extremes ranging from 44 to 86 years. The most represented age group was 65-74 years (53.5%).

3.2. Cardiovascular Risk Factors

Most patients had type 2 diabetes (95.35%), while type 1 diabetes accounted for 4.65%, with a mean disease duration of 14.3 years.

Hypertension was present in 63.95%, smoking in 20.9%, and alcohol consumption in 6.98% (Table 1).

3.3. Medical and Surgical History

More than half of the patients (55.8%) had no prior medical history.

The most frequent histories were angioplasty and minor disarticulation (10.5% each), followed by major amputation (9.3%). (Table 1)

Table 1. Epidemiological, clinical, paraclinical, operative and postoperative data.

Epidemiological characteristics of the patients
Characteristics	Value
Total number	86
Mean age (years)	66,3 ± 7,5
Age min-max (years)	44-86
Male sex	31 (36%)
Female sex	55 (64%)

Cardiovascular risk factors
Factor	Number	(%)
Type 2 Diabetes	82	95,35
Type 1 Diabetes	4	4,65
Hypertension	55	63,95
Smoking	18	20,9
Alcohol consumption	6	6,98

Patient history
History	Number	(%)
Lower-limb angioplasty	9	10,5
Minor Amputation	9	10,5
Miajor Amputation	8	9,3
Ischemic heart disease	6	7
Stroke	4	4,7

Location of involvement
Location	Number	(%)
Right lower limb	43	50
Left lower limb	39	45,35
Bilateral	4	4,65

Clinical stage of PAD
Stage	Number	(%)
IIb	4	4,65
III	9	10,5
IV	73	84,88

Preoperative ABI
ABI	Number	(%)
< 0,4	12	13,95
0,4 - 0,75	33	38,37
0,75 - 0,9	7	8,14
0,9-1,3	11	12,79
> 1,3 (medial calcification)	16	18,6
Not measured	7	8,14

Doppler ultrasound lesions
Artery	Occlusion (%)	Stenosis (%)	Total
Anterior tibial	15	24,5	39,5
Posterior tibial	13	20,7	33,7
Fibular	10,7	16,1	26,8

CT angiography lesions
Artery	Occlusion (%)	Stenosis (%)	Total
Anterior tibial	15	24,5	39,5
Fibular	10,7	16,1	26,8

Technical characteristics of angioplasty
Parameter	Value (%)
Local anesthesia	96,52
Anterograde puncture	98,8
Distal angioplasty alone	42
Distal + femoropopliteal angioplasty	44
3mm balloon	87,2
Femoral stent	1,16 (1 patient)

Amputations
Minor	Toes	12	46,1
Minor	Forefoot	6	23,1
Major	Leg	4	15,4
Major	Thigh	4	15,4
Total		26	100

3.4. Clinical Data

3.4.1. Location of Arterial Involvement

The right lower limb was affected in 50% of cases, the left in 45.35%, and bilateral involvement was observed in 4.65% (Table 1).

3.4.2. Clinical Stage

Most patients were classified as stage IV according to Leriche and Fontaine (84.88%) (Table 1).

3.4.3. Vascular Examination

Distal pulses were absent in 96.51% of patients.

Preoperative ABI indicated severe or moderate PAD in more than half of the cases (Table 1).

3.5. Paraclinical Data

1) Doppler ultrasound

A Doppler ultrasound was performed in 27.9% of patients.

2) CT angiography

CT angiography was performed in 97.67% of patients.

3.6. Therapeutic

Operative technique

1) Local anesthesia was used in 96.52% of procedures.

2) Antegrade puncture was performed in 98.8% of cases, reflecting its status as the predominant access route.

3) A 7F introducer was employed in 73.26% of interventions.

4) Distal angioplasty alone accounted for 42% of procedures, while a combined distal and femoropopliteal approach was required in 44% of cases.

5) A 3-mm balloon was used in 87.2% of angioplasties, consistent with the small caliber of tibial vessels.

6) Stent placement was exceptional, performed in only one patient. (Table 1)

3.7. Postoperative Outcomes

3.7.1. Per-procedure Complications

Residual stenosis was observed in 10.47% of procedures.

Arterial dissection occurred in 9.3% of cases.

3.7.2. Clinical Evolution and Postoperative ABI

The early postoperative period was marked by clear clinical improvement. Most patients showed:

1) A significant reduction in resting pain

2) A measurable improvement in ABI, indicating partial restoration of limb perfusion (Figure 1).

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Figure 1. Comparison of preoperative and postoperative ABI.

3.7.3. Wound Healing

Primary healing was achieved in 60.81% of patients.

The mean healing time was 4 months.

3.7.4. Amputations

A total of 26 amputations were performed: (Table 1)

1) 18 minor (12 toes, 6 forefoot)

2) 8 major (4 leg, 4 thigh)

3.7.5. Mortality

A total of 15 deaths (17.4%) were recorded after 15 months of follow-up

Main causes:

1) Myocardial infarction: 4

2) Heart failure: 2

3) Stroke: 1

4) Acute renal failure: 1

5) Unknown cause: 7

3.7.6. Correlation Analysis

1) Cardiovascular risk factors/history and risk of complications

Among cardiovascular risk factors, only ischemic heart disease was correlated with complications (p = 0.001) (Table 2).

2) Clinical stage and risk of death

There was no correlation between clinical stage and risk of death (p > 0.05),

Pearson chi² (3) = 7.4052 P-value = 0,06 (Table 2).

3) Cardiovascular risk factors and risk of death

Hypertension (p = 0.028) was the main cardiovascular risk factor associated with mortality (Table 2).

Table 2. Correlation analysis.

Cardiovascular risk factors/history and risk of complications
Risk factors		Number of complications			P-value
Risk factors		0	1	2	P-value
Hypertension	Yes	73,36	20	3,64	0,697
Hypertension	No	83,87	12,9	3,23	0,697
Smoking	Yes	83,33	16,67	0	0,652
Smoking	No	77,94	17,65	4,41	0,652
Alcohol consumption	Yes	83,33	16,67	0	0,886
Alcohol consumption	No	78,75	17,5	3,75	0,886
Ischemic heart disease	Yes	50	0	50	0,001
Ischemic heart disease	No	79,27	17,07	3,66	0,001
Diabetes type	Type 1	75	25	0	0,864
Diabetes type	Type 2	79,27	17,07	3,66	0,864
Diabetes duration (years)	< 5	75	25	0	0,123
	6 - 10	66,67	13,33	20
	11 - 15	92,31	7,69	0
	16 - 20	78,26	21,74	0
	21 - 30	80	20	0
	>30	80	20	0

Cardiovascular risk factors and risk of death
Risk factors		Death		P-value
Risk factors		Yes	No	P-value
Hypertension	Yes	28,26	71,74	0,028
Hypertension	No	7,14	92,86	0,028
Smoking	Yes	31,25	68,75	0,217
Smoking	No	17,24	82,76	0,217
Alcohol consumption	Yes	50	50	0,128
Alcohol consumption	No	18,57	81,43	0,128
Ischemic heart disease	Yes	50	50	0,289
Ischemic heart disease	No	19,44	80,56	0,289
Diabetes type	Type 1	50	50	0,128
Diabetes type	Type 2	18,57	81,43	0,128
Diabetes duration (years)	< 5	5,88	94,12	0,054
	6 - 10	25	75
	11 - 15	30,77	69,23

Clinical stages of PAD and risk of death
Stages	Death		P-value
Stages	Yes	No	P-value
Stage IIb	0	100	0,06
Stage III	42,86	57,14
Stage IV	17,74	82,26

3.7.7. Survival

Survival curve analysis showed a median post-angioplasty death time of 36 days.

At this observation point, 79 patients (91.8%) were still alive.

Download: Download full-size image

Figure 2. Survival curve.

4. Discussion

Distal angioplasty now occupies a central role in the management of chronic limb-threatening ischemia (CLTI) in diabetic patients, due to the predominance of infrapopliteal, diffuse, and calcified lesions in this population

[1, 2]

. Our study confirms this profile, with an overwhelming majority of patients classified as stage IV according to Leriche and Fontaine (84.88%), reflecting a late diagnosis—an expected situation in low-resource settings where delayed consultation, self-medication, and limited access to specialized care worsen the prognosis

[3, 5]

From an epidemiological standpoint, the mean age of 66 years and the female predominance observed in our cohort are consistent with global trends showing an increasing prevalence of PAD among diabetic women, likely related to prolonged exposure to risk factors and historical underrepresentation in screening programs

[5, 13]

. The mean duration of diabetes (14.3 years) is a major element, as long standing diabetes is strongly correlated with the progression of medial calcification, microangiopathy, and neuropathy—three factors that aggravate ischemia severity and delay wound healing

[7, 14]

Paraclinical data from our study confirm the multivessel and distal nature of the lesions, with predominant involvement of the tibial and peroneal arteries, as described in major international series

[9]

. The presence of incompressible arteries in 18.6% of cases reflects medial calcification, a hallmark of diabetic arteries, which complicates ABI interpretation and may mask the true severity of ischemia

[9]

. This particularity justifies complementary assessment with the toe-brachial index (TBI), particularly when ABI is unreliable because of medial arterial calcification, together with vascular imaging (Doppler ultrasound, CT angiography) for an accurate assessment of distal perfusion

[4]

From a technical perspective, distal angioplasty was performed under local anesthesia in 96.5% of cases, in line with current recommendations aimed at reducing anesthetic risks in frail, multimorbid patients

[15]

. Antegrade puncture, used in 98.8% of cases, is the preferred access route for infrapopliteal interventions, as it provides better device stability and more precise navigation in distal segments. The predominant use of 3 mm balloons reflects adaptation to the small caliber of tibial arteries, consistent with international standards

[16]

The immediate results of our study show a relatively low rate of per-procedure complications, with 10.47% residual stenosis and 9.3% arterial dissections. These figures are comparable to those reported in European and Asian series, where infrapopliteal dissections range from 5% to 15% depending on lesion complexity

[13, 17]

. The improvement in postoperative ABI demonstrates the hemodynamic effectiveness of revascularization, even in the context of complex and calcified lesions.

The primary healing rate (60.81%) observed in our study is encouraging and consistent with international data reporting healing rates between 50% and 70% after distal angioplasty in diabetic patients

[10, 18]

. The mean healing time of 4 months is also comparable to international series, where complete healing generally occurs between 3 and 6 months. However, healing remains strongly influenced by the quality of the distal run-off, the presence of infection, nutritional status, and multidisciplinary management—factors that are often difficult to optimize in African settings

[19, 20]

The major amputation rate (9.3%) observed in our study is lower than that reported in several African cohorts, where it may exceed 20%

[21, 22]

. This suggests that distal angioplasty, even in resource-limited settings, allows for significant limb salvage. However, the overall amputation rate (30.2%) remains high, reflecting the severity of initial lesions, the frequent presence of associated infections, and delays in management. This finding highlights the importance of early screening, strengthened therapeutic education, and multidisciplinary care involving diabetologists, infectious disease specialists, surgeons, and podiatrists.

The mortality rate of 17.4% is concerning but consistent with data showing that diabetic patients with critical ischemia have a high risk of cardiovascular death in the months following revascularization

[22, 23]

. In our series, hypertension was significantly associated with mortality (p=0.026), consistent with observations that overall cardiovascular burden is a major determinant of prognosis

[1, 5]

. The median survival of 36 days underscores the extreme fragility of this population

[24]

Finally, the absence of correlation between clinical stage and mortality in our study may be explained by the homogeneity of the population, largely dominated by the most severe stages, limiting statistical variability. This finding has also been reported in other series where the severity of comorbidities outweighs clinical classification in predicting prognosis

[7, 25]

Overall, our results confirm that distal angioplasty is an effective revascularization strategy in resource-limited settings, but its success depends heavily on comprehensive management of the diabetic patient, early diagnosis, and optimization of cardiovascular risk factors.

5. Conclusion

Distal angioplasty represents an essential revascularization strategy for diabetic patients presenting with severe lower limb ischemia. In our series, it resulted in significant hemodynamic improvement, satisfactory wound healing rates, and limb salvage in most of cases, despite the severity of lesions and the high prevalence of comorbidities. The outcomes obtained confirm the feasibility and effectiveness of this approach even in a resource limited setting.

However, the high mortality observed highlights the cardiovascular fragility of this population. It underscores the importance of comprehensive management integrating strict control of risk factors, early screening for PAD, and optimization of postoperative follow-up. Delayed access to care, associated infections, and medial calcification remain major obstacles to achieving optimal outcomes.

The development of multidisciplinary pathways dedicated to diabetic foot care, improved access to vascular imaging, and wider dissemination of endovascular techniques are essential levers for improving patient prognosis. Distal angioplasty must therefore be integrated into a global strategy of prevention, revascularization, and follow up to sustainably reduce the risk of amputation and mortality among diabetic patients.

6. Recommendations

The findings of this study highlight the need for earlier detection of peripheral arterial disease in diabetic patients and the implementation of structured multidisciplinary care pathways dedicated to diabetic foot management. Optimizing cardiovascular risk control, standardizing revascularization protocols, and reinforcing postoperative follow-up are essential to improve functional outcomes and reduce mortality.

From a research standpoint, prospective multicenter studies, evaluation of angiosome-guided strategies, analysis of early mortality predictors, and the establishment of a national diabetic foot registry represent key avenues for advancing knowledge and adapting therapeutic strategies to the realities of resource-limited settings.

Abbreviation

PAD	Peripheral Arterial Disease
CLTI	Chronic Limb-Threatening Ischemia
ABI	Ankle-Brachial Index
TBI	Toe-Brachial Index
CT	Computed Tomography
BTK	Below-The-Knee
PTA	Percutaneous Transluminal Angioplasty
7F	7 French (Introducer Size)
MM	Millimeter
IIb / III / IV	Leriche & Fontaine Clinical Stages

Author Contributions

Ndeye Fatou Sow: Funding acquisition, Project administration, Resources, Supervision, Validation, Writing – original draft, Writing – review & editing

Abdoul Aziz Thiaw: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Writing-original draft

Magaye Gaye: Methodology, Software, Validation, Visualization

Papa Adama Dieng: Formal Analysis, Validation, Visualization

Conflicts of Interest

The authors declare no conflicts of interest.

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Sow, N. F., Thiaw, A. A., Gaye, M., Diagne, M., Mbengue, A. A., et al. (2026). Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal. International Journal of Cardiovascular and Thoracic Surgery, 12(5), 113-121. https://doi.org/10.11648/j.ijcts.20261205.11

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Sow, N. F.; Thiaw, A. A.; Gaye, M.; Diagne, M.; Mbengue, A. A., et al. Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal. Int. J. Cardiovasc. Thorac. Surg. 2026, 12(5), 113-121. doi: 10.11648/j.ijcts.20261205.11

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AMA Style

Sow NF, Thiaw AA, Gaye M, Diagne M, Mbengue AA, et al. Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal. Int J Cardiovasc Thorac Surg. 2026;12(5):113-121. doi: 10.11648/j.ijcts.20261205.11

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@article{10.11648/j.ijcts.20261205.11,
  author = {Ndeye Fatou Sow and Abdoul Aziz Thiaw and Magaye Gaye and Moussa Diagne and Abdou Ahat Mbengue and Amadou Dioulde Diallo and Papa Adama Dieng},
  title = {Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {12},
  number = {5},
  pages = {113-121},
  doi = {10.11648/j.ijcts.20261205.11},
  url = {https://doi.org/10.11648/j.ijcts.20261205.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20261205.11},
  abstract = {Background: Distal angioplasty has become a key therapeutic option for diabetic patients presenting with chronic limb-threatening ischemia (CLTI), particularly in settings where infrapopliteal, diffuse, and calcified lesions are predominant. Despite the growing burden of diabetes in sub-Saharan Africa, regional data remain scarce. Methods: This retrospective, single?center study included all diabetic patients who underwent distal angioplasty at Fann Hospital between January 2021 and December 2022. Clinical characteristics, cardiovascular risk factors, imaging findings, procedural techniques, and postoperative outcomes were analyzed. Results: Eighty-six patients were included (mean age 66.3 ± 7.5 years). Most presented with stage IV ischemia (84.88%). Type 2 diabetes was predominant (95.35%), with a mean duration of 14.3 years. CT angiography revealed multivessel distal disease in nearly all cases. Distal angioplasty was performed under local anesthesia in 96.52% of procedures, with antegrade puncture in 98.8%. A 3mm balloon was used in 87.2% of cases, and stenting was required in only one patient. Residual stenosis occurred in 10.47% of procedures and arterial dissection in 9.3%. Primary wound healing was achieved in 60.81% of patients, with a mean healing time of 4 months. Twenty-six amputations were performed (18 minor, 8 major). Overall mortality reached 17.4%, with hypertension significantly associated with death (p = 0.028). Median survival after angioplasty was 36 days. Conclusion: Distal angioplasty is feasible and effective in diabetic patients with severe lower?limb ischemia, even in resource-limited settings. However, high mortality highlights the need for comprehensive cardiovascular management, early PAD detection, and strengthened multidisciplinary care pathways to improve long-term outcomes.},
 year = {2026}
}

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TY - JOUR
T1 - Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal
AU - Ndeye Fatou Sow
AU - Abdoul Aziz Thiaw
AU - Magaye Gaye
AU - Moussa Diagne
AU - Abdou Ahat Mbengue
AU - Amadou Dioulde Diallo
AU - Papa Adama Dieng
Y1 - 2026/09/02
PY - 2026
N1 - https://doi.org/10.11648/j.ijcts.20261205.11
DO - 10.11648/j.ijcts.20261205.11
T2 - International Journal of Cardiovascular and Thoracic Surgery
JF - International Journal of Cardiovascular and Thoracic Surgery
JO - International Journal of Cardiovascular and Thoracic Surgery
SP - 113
EP - 121
PB - Science Publishing Group
SN - 2575-4882
UR - https://doi.org/10.11648/j.ijcts.20261205.11
AB - Background: Distal angioplasty has become a key therapeutic option for diabetic patients presenting with chronic limb-threatening ischemia (CLTI), particularly in settings where infrapopliteal, diffuse, and calcified lesions are predominant. Despite the growing burden of diabetes in sub-Saharan Africa, regional data remain scarce. Methods: This retrospective, single?center study included all diabetic patients who underwent distal angioplasty at Fann Hospital between January 2021 and December 2022. Clinical characteristics, cardiovascular risk factors, imaging findings, procedural techniques, and postoperative outcomes were analyzed. Results: Eighty-six patients were included (mean age 66.3 ± 7.5 years). Most presented with stage IV ischemia (84.88%). Type 2 diabetes was predominant (95.35%), with a mean duration of 14.3 years. CT angiography revealed multivessel distal disease in nearly all cases. Distal angioplasty was performed under local anesthesia in 96.52% of procedures, with antegrade puncture in 98.8%. A 3mm balloon was used in 87.2% of cases, and stenting was required in only one patient. Residual stenosis occurred in 10.47% of procedures and arterial dissection in 9.3%. Primary wound healing was achieved in 60.81% of patients, with a mean healing time of 4 months. Twenty-six amputations were performed (18 minor, 8 major). Overall mortality reached 17.4%, with hypertension significantly associated with death (p = 0.028). Median survival after angioplasty was 36 days. Conclusion: Distal angioplasty is feasible and effective in diabetic patients with severe lower?limb ischemia, even in resource-limited settings. However, high mortality highlights the need for comprehensive cardiovascular management, early PAD detection, and strengthened multidisciplinary care pathways to improve long-term outcomes.
VL - 12
IS - 5
ER -

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Author Information

Ndeye Fatou Sow

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal

http://orcid.org/0009-0009-9001-6850
Abdoul Aziz Thiaw

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal

Contact Email

http://orcid.org/0009-0006-5360-9030
Magaye Gaye

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal
Moussa Diagne

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal
Abdou Ahat Mbengue

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal
Amadou Dioulde Diallo

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal
Papa Adama Dieng

Thoracic and Cardiovascular Surgery Department, National University Hospital Center of Fann, Dakar, Senegal

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APA Style

Sow, N. F., Thiaw, A. A., Gaye, M., Diagne, M., Mbengue, A. A., et al. (2026). Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal. International Journal of Cardiovascular and Thoracic Surgery, 12(5), 113-121. https://doi.org/10.11648/j.ijcts.20261205.11

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ACS Style

Sow, N. F.; Thiaw, A. A.; Gaye, M.; Diagne, M.; Mbengue, A. A., et al. Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal. Int. J. Cardiovasc. Thorac. Surg. 2026, 12(5), 113-121. doi: 10.11648/j.ijcts.20261205.11

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AMA Style

Sow NF, Thiaw AA, Gaye M, Diagne M, Mbengue AA, et al. Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal. Int J Cardiovasc Thorac Surg. 2026;12(5):113-121. doi: 10.11648/j.ijcts.20261205.11

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@article{10.11648/j.ijcts.20261205.11,
  author = {Ndeye Fatou Sow and Abdoul Aziz Thiaw and Magaye Gaye and Moussa Diagne and Abdou Ahat Mbengue and Amadou Dioulde Diallo and Papa Adama Dieng},
  title = {Distal Angioplasty in Diabetic Patients: A Two-Year Retrospective Study at Fann University Hospital, Dakar, Senegal},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {12},
  number = {5},
  pages = {113-121},
  doi = {10.11648/j.ijcts.20261205.11},
  url = {https://doi.org/10.11648/j.ijcts.20261205.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20261205.11},
  abstract = {Background: Distal angioplasty has become a key therapeutic option for diabetic patients presenting with chronic limb-threatening ischemia (CLTI), particularly in settings where infrapopliteal, diffuse, and calcified lesions are predominant. Despite the growing burden of diabetes in sub-Saharan Africa, regional data remain scarce. Methods: This retrospective, single?center study included all diabetic patients who underwent distal angioplasty at Fann Hospital between January 2021 and December 2022. Clinical characteristics, cardiovascular risk factors, imaging findings, procedural techniques, and postoperative outcomes were analyzed. Results: Eighty-six patients were included (mean age 66.3 ± 7.5 years). Most presented with stage IV ischemia (84.88%). Type 2 diabetes was predominant (95.35%), with a mean duration of 14.3 years. CT angiography revealed multivessel distal disease in nearly all cases. Distal angioplasty was performed under local anesthesia in 96.52% of procedures, with antegrade puncture in 98.8%. A 3mm balloon was used in 87.2% of cases, and stenting was required in only one patient. Residual stenosis occurred in 10.47% of procedures and arterial dissection in 9.3%. Primary wound healing was achieved in 60.81% of patients, with a mean healing time of 4 months. Twenty-six amputations were performed (18 minor, 8 major). Overall mortality reached 17.4%, with hypertension significantly associated with death (p = 0.028). Median survival after angioplasty was 36 days. Conclusion: Distal angioplasty is feasible and effective in diabetic patients with severe lower?limb ischemia, even in resource-limited settings. However, high mortality highlights the need for comprehensive cardiovascular management, early PAD detection, and strengthened multidisciplinary care pathways to improve long-term outcomes.},
 year = {2026}
}

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