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Diabetic foot endovascular

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https://www.readbyqxmd.com/read/27667151/elevated-serum-phosphate-levels-are-associated-with-decreased-amputation-free-survival-after-interventions-for-critical-limb-ischemia
#1
Sara L Zettervall, Peter A Soden, Klaas H J Ultee, Crystal Seldon, Jinhee Oh, Kevin McGann, Marc L Schermerhorn, Raul J Guzman
OBJECTIVE: Elevated serum phosphate levels have been associated with increased risks of cardiovascular events and death in several patient populations. The effects of serum phosphate on outcomes in patients with critical limb ischemia (CLI) have not been evaluated. In this study, we assessed the effect of abnormal phosphate levels on mortality and major limb events after surgical intervention for CLI. METHODS: A retrospective review was undertaken to identify all patients at a single institution who underwent a first-time open or endovascular intervention for CLI between 2005 and 2014...
September 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27565588/the-financial-burden-of-surgical-and-endovascular-treatment-of-diabetic-foot-wounds
#2
Maximilian O Joret, Anastasia Dean, Colin Cao, Joanna Stewart, Venu Bhamidipaty
OBJECTIVE: The cost of treating diabetes-related disease in New Zealand is increasing and is expected to reach New Zealand dollars (NZD) 1.8 billion in 2021. The financial burden attached to the treatment of diabetic foot wounds is difficult to quantify and reported costs of treatment vary greatly in the literature. As of yet, no study has captured the true total cost of treating a diabetic foot wound. In this study, we investigate the total minimum cost of treating a diabetic foot ulcer at a tertiary institution...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27428500/determinants-of-decreasing-major-amputation-rates-in-germany
#3
Carolin Pütter, Jürgen Stausberg, Olga von Beckerath, Holger Reinecke, Erika Schäfer, Knut Kröger
BACKGROUND: We analysed a potential association between the decrease in major amputations in Germany and the number of doctors, prescribed podologic foot care (PFC) and antidiabetic drugs, and performed percutaneous endoluminal angioplasties (PTA). PATIENTS AND METHODS: Data of all lower limb major amputations between 2007 and 2011, the cases hospitalised with an additional diagnosis of diabetes mellitus, and the numbers of PTAs, and the number of doctors in private practices and in hospitals were obtained from the Federal Statistical Office...
2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27321326/long-term-outcomes-of-diabetic-haemodialysis-patients-with-critical-limb-ischemia-and-foot-ulcer
#4
Marco Meloni, Laura Giurato, Valentina Izzo, Matteo Stefanini, Enrico Pampana, Roberto Gandini, Luigi Uccioli
AIM: To evaluate the outcomes of diabetic dialysis patients with critical limb ischemia and foot ulcer. METHODS: The study group included 599 diabetic, 99 dialyzed (Ds) (16.5%) and 500 not dialyzed (NDs) (83%) patients with critical limb ischemia and foot ulcers identified as stage C (ischemia) or D (ischemia plus infection) of Texas Wound Classification. All patients were treated by endovascular revascularization. Outcomes were expressed as healing, major amputation, death and non healing after 12months...
December 0: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27219884/clinical-evaluation-of-human-umbilical-cord-mesenchymal-stem-cell-transplantation-after-angioplasty-for-diabetic-foot
#5
H L Qin, X H Zhu, B Zhang, L Zhou, W Y Wang
Aims: The multilineage differentiation potential of human umbilical cord mesenchymal stem cells (HUCMSCs) holds therapeutic promise for non-healing ulcers and tissue regeneration. The present study evaluated the effects of HUCMSC transplantation after angioplasty for treatment of diabetic foot. Methods: Included in the study were 53 patients (72 limbs) with severe symptoms of Fontaine II-IV diabetic foot accompanied by varying degrees of lower extremity arterial disease. The patients were randomly apportioned to a control group (25 patients; 38 limbs) or an experimental group (28 patients; 34 limbs)...
May 24, 2016: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/27065215/using-noncontact-infrared-thermography-for-long-term-monitoring-of-foot-temperatures-in-a-patient-with-diabetes-mellitus
#6
Erik Staffa, Vladan Bernard, Luboš Kubíček, Robert Vlachovský, Daniel Vlk, Vojtěch Mornstein, Robert Staffa
Foot complications in persons with diabetes mellitus (DM) are associated with substantial costs and loss of quality of life. Increasing evidence suggests changes in skin temperature, measured using an infrared thermographic system (IRT), may be a predictor of foot ulcer development in patients with DM. The purpose of this case study is to describe the long-term IRT findings and overall clinical outcomes of a patient with DM and peripheral vascular disease. Foot temperature measurements using IRT were obtained slightly more than 1 year before and immediately following endovascular treatment of a 76-year-old man, a nonsmoker with type 2 DM, hypertension, and ischemic heart disease with cardiac arrhythmia...
April 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27036309/society-for-vascular-surgery-limb-stage-and-patient-risk-correlate-with-outcomes-in-an-amputation-prevention-program
#7
Marlin W Causey, Ayman Ahmed, Bian Wu, Warren J Gasper, Alex Reyzelman, Shant M Vartanian, Jade S Hiramoto, Michael S Conte
OBJECTIVE: Clinical decision making and accurate outcomes comparisons in advanced limb ischemia require improved staging systems. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) was designed to stratify limb outcomes based on three major factors-wound extent, ischemia, and foot infection. The Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk score was developed to stratify patients by expected amputation-free survival (AFS) after surgical revascularization...
June 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27015337/combination-of-vascular-intervention-surgery-and-free-tissue-transfer-for-critical-diabetic-limb-salvage
#8
Chieh Chou, Pao-Jen Kuo, Yen-Chou Chen, Shu-Hung Huang, Chih-Hau Chang, Yi-Chia Wu, Su-Shin Lee, Cheng-Sheng Lai, Sin-Daw Lin, Kao-Ping Chang, Yur-Ren Kuo
BACKGROUND: Complex, nontraumatic diabetic foot ulcers with peripheral vascular compromise often lead to extensive lower-limb amputation. The aim of this study is to determine the outcome of combined vascular intervention and free tissue transfer for critical diabetic limb salvage. MATERIALS AND METHODS: A total of 26 consecutive diabetic patients with 28 legs with diabetic foot ulcers who underwent limb salvage with a combination of revascularization (bypass surgery or endovascular angioplasty) and free flap transfers were reviewed...
February 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/26994958/validation-of-the-wound-ischemia-foot-infection-wifi-classification-system-in-nondiabetic-patients-treated-by-endovascular-means-for-critical-limb-ischemia
#9
Efthymios Beropoulis, Konstantinos Stavroulakis, Arne Schwindt, Arne Stachmann, Giovanni Torsello, Theodosios Bisdas
BACKGROUND: The Society for Vascular Surgery Lower Extremity Guidelines Committee developed the Wound, Ischemia, foot Infection (WIfI) a classification system to predict the amputation risk in patients with critical limb ischemia (CLI). A number of published studies have already evaluated its prognostic value. However, most of the included patients were diabetic, and the validation was done independent of the revascularization procedure. This single-center study evaluated the prognostic value of WIfI stages in nondiabetic patients treated by endovascular means...
July 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26927956/collagen-implant-with-gentamicin-sulphate-as-an-option-to-treat-a-neuroischaemic-diabetic-foot-ulcer-case-report
#10
C E Costa Almeida
INTRODUCTION: The ischaemic diabetic foot is associated with a faster evolving atherosclerosis affecting preferentially the bellow knee arteries. This distal ischemia associated with a wide distribution of multiple stenosis and occlusions throughout lower limb arteries, makes revascularization very hard or even impossible. This represents a major factor responsible for non-healing diabetic foot ulcer. In these cases all efforts should be made to find treatment alternatives that can promote ulcer healing...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/26804367/the-management-of-diabetic-foot-a-clinical-practice-guideline-by-the-society-for-vascular-surgery-in-collaboration-with-the-american-podiatric-medical-association-and-the-society-for-vascular-medicine
#11
Anil Hingorani, Glenn M LaMuraglia, Peter Henke, Mark H Meissner, Lorraine Loretz, Kathya M Zinszer, Vickie R Driver, Robert Frykberg, Teresa L Carman, William Marston, Joseph L Mills, Mohammad Hassan Murad
BACKGROUND: Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline...
February 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26802295/the-use-of-the-angiosome-concept-for-treating-infrapopliteal-critical-limb-ischemia-through-interventional-therapy-and-determining-the-clinical-significance-of-collateral-vessels
#12
Xiang-Tao Zheng, Rui-Chao Zeng, Jing-Yong Huang, Le-Men Pan, Xiang Su, Zi-Heng Wu, Guan-Feng Yu
BACKGROUND: The purpose of this study was to evaluate the clinical significance of the involvement of collateral vessels in interventional therapy based on the angiosome concept for infrapopliteal critical limb ischemia (CLI). METHODS: We enrolled 486 patients with unilateral infrapopliteal CLI (Rutherford Stage 5 or 6) treated at 2 hospitals from January 2005 to December 2014. Using the angiosome concept, the patients were categorized into 3 groups: the direct revascularization (DR) group, the indirect revascularization through collaterals (IR-tc) group, and the indirect revascularization without collaterals (IR-wc) group...
April 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26632661/management-of-critical-limb-ischemia-in-the-patient-with-diabetes
#13
REVIEW
Rachael O Forsythe, Robert J Hinchliffe
Management of peripheral artery disease (PAD) and critical limb ischemia (CLI) in the patient with diabetes is an ever-important challenge for the vascular specialist. Patients with diabetes and CLI represent a unique subset--due to the different etiology, clinical presentation and outcomes compared to patients with CLI but no diabetes--and are at a high risk for the development of diabetic foot ulceration. The presence of PAD in a patient with diabetic foot ulceration is in turn associated with much poorer outcomes, including failure to heal wounds and, ultimately, increased risk of limb loss, as well as increased overall cardiovascular mortality...
April 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/26455728/lower-limb-ischaemia-in-patients-with-diabetic-foot-ulcers-and-gangrene-recognition-anatomic-patterns-and-revascularization-strategies
#14
Joseph L Mills
The confluence of several chronic conditions--in particular ageing, peripheral artery disease, diabetes, and chronic kidney disease--has created a global wave of lower limbs at risk for major amputation. While frequently asymptomatic or not lifestyle limiting, at least 1% of the population has peripheral artery disease of sufficient severity to be limb threatening. To avoid the critical error of failing to diagnose ischaemia, all patients with diabetic foot ulcers and gangrene should routinely undergo physiologic evaluation of foot perfusion...
January 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/26451519/the-diabetic-foot-in-2015-an-overview
#15
K Markakis, F L Bowling, A J M Boulton
In 2015, it can be said that the diabetic foot is no longer the Cinderella of diabetic complications. Thirty years ago there was little evidence-based research taking place on the diabetic foot, and there were no international meetings addressing this topic. Since then, the biennial Malvern Diabetic Foot meetings started in 1986, the American Diabetes Association founded their Foot Council in 1987, and the European Association for the Study of Diabetes established a Foot Study Group in 1998. The first International Symposium on the Diabetic Foot in The Netherlands was convened in 1991, and this was soon followed by the establishment of the International Working Group on the Diabetic Foot that has produced useful guidelines in several areas of investigation and the management of diabetic foot problems...
January 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/26370745/diabetic-foot-infection-preliminary-results-of-a-fast-track-program-with-early-endovascular-revascularization-and-local-surgical-treatment
#16
Nicola Troisi, Leonardo Ercolini, Emiliano Chisci, Cristiana Baggiore, Tania Chechi, Francesco Manetti, Barbara Del Pin, Roberto Virgili, Giangiuseppe Alberti Lepri, Giancarlo Landini, Stefano Michelagnoli
BACKGROUND: To demonstrate that a fast-track program consisting in early endovascular revascularization and local surgical treatment saves tissue in patients with diabetic foot infection (DFI). METHODS: Between January and December 2014, 48 patients with DFI underwent early endovascular revascularization and local surgical treatment at our Diabetic Foot Center. In all cases, endovascular revascularization and local surgical treatment were performed within 1 week from the diagnosis of infection and during the same hospital stay...
January 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26342204/effectiveness-of-revascularization-of-the-ulcerated-foot-in-patients-with-diabetes-and-peripheral-artery-disease-a-systematic-review
#17
REVIEW
R J Hinchliffe, J R W Brownrigg, G Andros, J Apelqvist, E J Boyko, R Fitridge, J L Mills, J Reekers, C P Shearman, R E Zierler, N C Schaper
Symptoms or signs of peripheral artery disease (PAD) can be observed in up to 50% of the patients with a diabetic foot ulcer and is a risk factor for poor healing and amputation. In 2012, a multidisciplinary working group of the International Working Group on the Diabetic Foot published a systematic review on the effectiveness of revascularization of the ulcerated foot in patients with diabetes and PAD. This publication is an update of this review and now includes the results of a systematic search for therapies to revascularize the ulcerated foot in patients with diabetes and PAD from 1980 to June 2014...
January 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/26161103/clinical-and-morphological-features-of-patients-who-underwent-endovascular-interventions-for-lower-extremity-arterial-occlusive-diseases
#18
Sakir Arslan, Isa Oner Yuksel, Erkan Koklu, Goksel Cagirci, Cagin Mustafa Ureyen, Nermin Bayar, Selcuk Kucukseymen, Gorkem Kus
INTRODUCTION: Patients with peripheral arterial disease (PAD) are at increased risk for all-cause mortality and cardiovascular mortality. AIM: To present anatomical and morphological characteristics of patients who underwent endovascular stenting with laboratory and our mid-term results. MATERIAL AND METHODS: One hundred fifty-three patients (mean age: 62.8, 86% male) who underwent percutaneous intervention of lower extremity arteries were included in the study...
2015: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/25874473/-vascular-medicine-needs-more-evidence-recent-results-and-meta-analyses-for-the-treatment-of-diabetic-feet
#19
G Torsello, S Debus, F Meyer, R T Grundmann
BACKGROUND: This overview comments on clinical trials and meta-analyses from the literature on the treatment of diabetic feet. METHODS: For the literature review, the MEDLINE database (PUBMED) was searched under the key words "diabetic foot". Publications of the last three years (2012 to 2014) were extracted. RESULTS: For patients with diabetic feet, both endovascular (ER) and open (OR) revascularisation techniques are possible. There are not sufficient data to demonstrate whether open bypass surgery or endovascular interventions are more effective in these patients...
April 2015: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/25704905/infrapopliteal-arterial-recanalization-a-true-advance-for-limb-salvage-in-diabetics
#20
REVIEW
J-M Pernès, M Auguste, H Borie, S Kovarsky, A Bouchareb, C Despujole, G Coppé
The world is facing an epidemic of diabetes; consequently in the next years, critical limb ischemia (CLI) due to diabetic arterial disease, characterized by multiple and long occlusions of below-the-knee (BTK) vessels, will become a major issue for vascular operators. Revascularization is a key therapy in these patients as restoring adequate blood supply to the wound is essential for healing, thus avoiding major amputations. Endoluminal therapy for BTK arteries is now a key part of the vascular specialist armamentarium...
May 2015: Diagnostic and Interventional Imaging
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