Endovascular surgical interventions for the correction of critical lower limb ischemia in diabetic foot syndrome

Authors

  • V. P. Polyovyy Bukovinian State Medical University, Chernivtsi
  • B. Khorshani Bukovinian State Medical University, Chernivtsi
  • O. Y. Khomko Bukovinian State Medical University, Chernivtsi
  • R. I. Sydorchuk Bukovinian State Medical University, Chernivtsi
  • P. M. Voljanjuk Bukovinian State Medical University, Chernivtsi
  • I. I. Bilyk Bukovinian State Medical University, Chernivtsi

DOI:

https://doi.org/10.11603/2414-4533.2019.4.10716

Keywords:

diabetic foot syndrome, stenotic-occlusive vascular lesions, endovascular surgery, balloon angioplasty, critical lower extre­mity ischemia

Abstract

The aim of the work: to analyze the possibilities of endovascular correction of stenotic-occlusive lesions of the arteries of the popliteal-ankle-foot segment with diabetic foot syndrome and critical lower limb ischemia.

Materials and Methods. The study is based on the analysis of the results of clinical observation and treatment of 87 patients with diabetic foot syndrome with stenotic-occlusive lesions of the arteries of the popliteal and foot-segment and development of critical limb ischemia (mean age (67.3±8.35 years). The main indication for endovascular arterial intervention was lower limb ischemia degree 4 by Fontaine. The criterion for evaluating the effectiveness of surgery in this study was considered to be residual stenosis less than 30.

Results and Discussion. The use of endovascular interventions for stenotic-occlusive lesions of the arteries of the lower leg leads to the restoration of patency of the arteries and immediate clinical success in 94.3 % of observations. Adverse factors affecting the clinical outcome of the operation are the combined lesion of the arteries of the lower leg and the length of the lesions of the arteries more than 5 cm. pathology, lack of plastic material or common trophic changes in the affected limb.

References

Iftodii, AH., Reva, W.B., Rusak, O.B., Silver, I.M., Reva, T.V., & Sydorchuk, R.I. (2018). Vnutrishniotkanynnyi elektroforez izoketu v kompleksnomu likuvanni khvorykh na obliteruiuchyi ateroskleroz: vplyv na systemnyi koahuliatsiinyi potentsial [Intracellular isokette electrophoresis in the multimodal treatment of patients with obliterating atherosclerosis: influence on systemic coagulation potential]. Ukrainskyi zhurnal ekstremalnoi medytsyny im. H.О. Mozhaieva – Ukrainian Journal of Extreme Medicine named after H.O. Mozhaiev, 19(3), 12-15 [in Ukrainian].

Zhang, P., Lu, Q., Li, H., Wang, W., Li, G., Si, L., & Ding, Y. (2019). The quality of guidelines for diabetic foot ulcers: A critical appraisal using the AGREE II instrument. PLoS One, 14 (9). e0217555. doi: 10.1371/journal.pone.0217555. DOI: https://doi.org/10.1371/journal.pone.0217555

Hinchliffe, R.J., Brownrigg, J.R., Apelqvist, J., Boyko, E.J., Fitridge, R., Mills, J.L., et al. (2016). IWGDF guidance on the diagnosis, prognosis and management of peripheral artery disease in patients with foot ulcers in diabetes. Diabetes/metabolism Research and Reviews, 32 (1), 37-44. Epub 2015/09/04. 10.1002/dmrr.2698. DOI: https://doi.org/10.1002/dmrr.2698

Game, F.L., Attinger, C., Hartemann, A., Hinchliffe, R.J., Londahl, M., Price, P.E., et al. (2016). IWGDF guidance on use of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metabolism Research and Reviews, 32 (1), 75-83. Epub 2015/09/06. 10.1002/dmrr.2700. DOI: https://doi.org/10.1002/dmrr.2700

Sydorchuk, R.I., Khomko, O.J., Reva, V.B., Polianskyi, O.I., Sydorchuk, L.P., & Popovych, A.I. (2017). Morfolohichni zminy pry syndromi diabetychnoi stopy [Morphological changes in diabetic foot syndrome]. Klinichna khirurhiia – Clinical Surgery, 10 (906), 44-45 [in Ukrainian].

Miller, J.D., Carter, E., & Shih, J. (2014). How to do a 3-minute diabetic foot exam. J. Fam. Pract., 63, 646-649, 653-656.

Hingorani, A., LaMuraglia, G.M., Henke, P., Meissner, M.H., Loretz, L., Zinszer, K.M., et al. (2016). 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. Journal of Vascular Surgery, 63 (2 Suppl), 3s-21s. Epub 2016/01/26. 10.1016/j.jvs.2015.10.003. DOI: https://doi.org/10.1016/j.jvs.2015.10.003

Published

2020-01-11

How to Cite

Polyovyy, V. P., Khorshani, B., Khomko, O. Y., Sydorchuk, R. I., Voljanjuk, P. M., & Bilyk, I. I. (2020). Endovascular surgical interventions for the correction of critical lower limb ischemia in diabetic foot syndrome. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 85–88. https://doi.org/10.11603/2414-4533.2019.4.10716

Issue

Section

EXPERIENCE OF WORK