Table 2.

Associations and outcomes of hyperglycemia and management by vascular procedure

Carotid endarterectomy	Perioperative glucose is associated with increased perioperative stroke, MI, and death after carotid endarterectomy [50].
Carotid artery stenting	Patients with impaired fasting glucose in the 24 h before surgery were more likely to suffer a major adverse effect (death, MI, stroke; 26 vs. 12%, p <0.001) in the 90-day post-operative period [51].
Infrainguinal bypass	Higher perioperative glucose area under the curve is associated with 13.4-fold increase of surgical wound complications at 30 days [52]. No difference in surgical site infection, cardiac, and pulmonary events in optimal versus suboptimal glucose control (p = 1.0). Length of stay was lower in optimal control group (4.2 vs. 7.3 days, p = 0.02) [53].
Open and endovascular procedures of lower extremity	Patients with postoperative hyperglycemia (BG > 180) had higher length of stay (6.9 vs. 5.1 days; p < 0.0001), higher Charlson Comorbidity Index scores (3.4 vs. 2.5, p < 0.0001), higher infection rates (23 vs. 14%, p < 0.0001), and more acute complications (e.g., fluid and electrolyte disorders, acute renal failure) than patients with optimal glucose control. 30-day readmission and major amputations were similar [54•].
Amputation	Comparing a preoperative random glucose of > 196 vs. <126 mg/dl, the hazard ratio for amputation was 0.77 (95% CI 0.16–3.62) and 1.90 (95% CI 0.50–7.22) for mortality at 3 months. [55].
General vascular surgery	In patients with PAD undergoing revascularization, each 1% rise in A1C above 6.0% was associated with a 25% (1.26; 95% CI 1.15–1.39) higher risk of amputation and a 105% (HR 2.05; 95% CI 1.87–2.26) increased risk of a major adverse limb event [56]. When comparing tight control and standard of care, there was significant reduction in risk for their composite endpoint of all-cause mortality, MI, and acute congestive heart failure (p = 0.01) but no difference in glycemic control [57].