Clinical characteristics of Japanese diabetic patients with critical limb ischemia presenting Fontaine stage IV

  • Mitsuyoshi TakaharaEmail author
  • Osamu Iida
  • Yukihiro Fujita
  • Masakazu Haneda
Short Communication


The aim of the current study was to reveal the clinical characteristics of Japanese diabetic patients with critical limb ischemia (CLI) presenting ischemic unhealed ulcer/gangrene (Fontaine stage IV) in the real-world settings. The current retrospective cross-sectional study included consecutive 282 Japanese diabetic patients who underwent endovascular therapy for CLI presenting Fontaine stage IV. The prevalence of diabetes-related complications was estimated adopting multiple imputation (50 times). The patients were aged 70 ± 10 years. Median duration of diabetes was 21 (interquartile range 12–31) years. The prevalence of proliferative diabetic retinopathy, end-stage renal disease on regular dialysis, stroke, coronary artery disease, and chronic heart failure was estimated at 48% (95% confidence interval 39–56%), 52% (46–58%), 34% (28–39%), 48% (42–54%), and 35% (29–41%), respectively. The prevalence of stroke, coronary artery disease, and chronic heart failure was not significantly associated with the duration of diabetes (all p > 0.05). On the other hand, the prevalence of proliferative diabetic retinopathy and end-stage renal disease on regular dialysis was significantly positively associated with the duration of diabetes (both p < 0.05). However, these prevalences reached as high as ~ 30% even in patients with duration of diabetes < 10 years. In conclusion, the advanced stage of diabetes-related complications was prevalent in patients with CLI presenting Fontaine stage IV.


Critical limb ischemia Fontaine stage IV Diabetes-related complication Prevalence 



This study was supported by a Grant-in-Aid (No. 201709007A and No. 201608012A) for Scientific Research from the Ministry of Health, Labour and Welfare of Japan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interests associated with this manuscript.

Human rights statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revision.


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Copyright information

© The Japan Diabetes Society 2018

Authors and Affiliations

  1. 1.Department of Diabetes Care MedicineOsaka University Graduate School of MedicineSuitaJapan
  2. 2.Cardiovascular CenterKansai Rosai HospitalAmagasakiJapan
  3. 3.Division of Metabolism and Biosystemic Science, Department of Internal MedicineAsahikawa Medical UniversityAsahikawaJapan

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