LONG-TERM RESULTS AFTER POPLITEAL-PEDAL BYPASS IN DIABETIC FOOT PATIENTS
DOI:
https://doi.org/10.11603/1681-2786.2025.1.15354Keywords:
diabetic foot popliteal-pedal bypass; acute arterial thrombosis.Abstract
Purpose: The evaluation of the long-term results after popliteal-pedal bypass in diabetic foot patients. Materials and methods. In this retrospective single-center study between January 2011 and June 2016 were selected diabetic patients WIfI 2–3, with chronic limb-threatening ischemia (CLTI) Rutherford III-IV category: men 27 (46,6%), women – 31 (53,4%); average age 68 year ±5,6 year (n=58). Results. The mean preoperative ABPI was 0.4 to 1,2 and depend of Menkenbergs calcinoses. According to preoperative DUS in all patients were detected occlusive-stenotic lesion on BTK arteries, the type of Doppler spectrum curve on the foot arteries blood flow with lower peripheral resistance (RI < 0.83) in 31 (53.4%) patients, blood flow with high peripheral resistance (RI = 1.0) – in 19 (32.8%), pedal artery’s lumen was detected – in 8 (13.8%). ТсРО2 on the foot was (11.2 ±6.2) mm. Hg. The ABPI were used to evaluate the hemodynamic response after operation, was the good determinant technical success and clinical improvement, but we did not find any correlation with preoperative data. Wound healing after the intervention on the foot during 1–2 weeks occurred in 46 (79.3%), repeated intervention including autodermoplasty made wound healed within 1.5-2 months in 7 (12.1%) patients. Conclusions. Limb salvage and CLTI patients survival after open surgery who were not performed major amputation after revascularization were comparable regardless of treatment method.
References
Criqui M. H., Matsushita K., Aboyans V., Hess C. N., Hicks C. W., Kwan T. W. et al. Lower extremity peripheral artery disease: contemporary epidemiology, management gaps, and future directions: a scientific statement from the American Heart Association. Circulation. 2021. Vol. 144. P. e171–e191. DOI: https://doi.org/10.1161/CIR.0000000000001019
Aday A. W., Matsushita K. Epidemiology of peripheral artery disease and polyvascular disease. Circ Res. 2021. Vol. 128. P. 1818–1832. DOI: https://doi.org/10.1161/CIRCRESAHA.121.318535
Nordanstig J., Behrendt C. A., Baumgartner I., Belch J., Back M., Fitridge R. et al. Editor’s choice—European Society for Vascular Surgery (ESVS) 2024 clinical practice guidelines on the management of asymptomatic lower limb peripheral arterial disease and intermittent claudication. Eur J Vasc Endovasc Surg. 2024. Vol. 67. P. 9–96. DOI: https://doi.org/10.1016/j.ejvs.2023.08.067
National Institute for Health and Care Excellence. Peripheral arterial disease: diagnosis and management (CG147). London, 2012 (updated 2020).
Song P., Rudan D., Zhu Y., Fowkes F. J. I., Rahimi K., Fowkes F. G. R. et al. Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. Lancet Glob Health. 2019. Vol. 7. P. e1020–e1030. DOI: https://doi.org/10.1016/S2214-109X(19)30255-4
Nehler M. R., Duval S., Diao L., Annex B. H., Hiatt W. R., Rogers K. et al. Epidemiology of peripheral arterial disease and critical limb ischemia in an insured national population. J Vasc Surg. 2014. Vol. 60. P. 686–695.e2. DOI: https://doi.org/10.1016/j.jvs.2014.03.290
Fowkes F. G., Rudan D., Rudan I., Aboyans V., Denenberg J. O., McDermott M. M. et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013. Vol. 382. P. 1329–1340. DOI: https://doi.org/10.1016/S0140-6736(13)61249-0
Vascular Services Quality Improvement Programme. 2022 Annual Report. 2022. URL: https://www.vsqip.org.uk/reports-publications/2022-annual-report/ (дата звернення: 20.03.2023).
Kengne A. P., Echouffo-Tcheugui J. B. Differential burden of peripheral artery disease. Lancet Glob Health. 2019. Vol. 7. P. e980–e981. DOI: https://doi.org/10.1016/S2214-109X(19)30293-1
Treat-Jacobson D., McDermott M. M., Bronas U. G., Campia U., Collins T. C., Criqui M. H. et al. Optimal exercise programs for patients with peripheral artery disease: a scientific statement from the American Heart Association. Circulation. 2019. Vol. 139. P. e10–e33. DOI: https://doi.org/10.1161/CIR.0000000000000623
Lane R., Harwood A., Watson L., Leng G. C. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2017. Issue 12. P. CD000990. DOI: https://doi.org/10.1002/14651858.CD000990.pub4
Behrendt C. A., Bertges D., Eldrup N., Beck A. W., Mani K., Venermo M. et al. International Consortium of Vascular Registries consensus recommendations for peripheral revascularisation registry data collection. Eur J Vasc Endovasc Surg. 2018. Vol. 56. P. 217–237. DOI: https://doi.org/10.1016/j.ejvs.2018.04.006
Bradbury A. W., Kolh P., Conte M. S., GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS). Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur J Vasc Endovasc Surg. 2019. Vol. 58, Issue 1– P. 1–xx.
Didenko S. N., Ratushniuk A. V., Liksunov O. V., Orlych O. M., Hupalo Y. M., Makivchuk D. A. Fine-needle angiography in chronic limb-threatening ischemia diabetic patients. Wiad Lek. 2022. Vol. 75(11, pt 1). P. 2581–2584. doi: 10.36740/WLek202211104 DOI: https://doi.org/10.36740/WLek202211104
Meyer A., Boxberger E., Behrendt C. A., Yagshyyev S., Welk I., Lang W., Rother U. Long-Term Outcomes of Extra-Anatomic Femoro-Tibial Bypass Reconstructions in Chronic Limb-Threatening Ischemia. J Clin Med. 2022. Vol. 11(5). P. 1237. doi: 10.3390/jcm11051237 DOI: https://doi.org/10.3390/jcm11051237
Rümenapf G., Morbach S., Rother U., Uhl C., Görtz H., Böckler D. et al. Diabetisches Fußsyndrom – Teil 2 : Revaskularisation, Behandlungsalternativen, Versorgungsstrukturen, Rezidivprophylaxe. Chirurg. 2021Vol. 92(2). P. 173–186. doi: 10.1007/s00104-020-01313-5 DOI: https://doi.org/10.1007/s00104-020-01313-5
Abdelaty M. H., Aborahma A. M., Elheniedy M. A., Kamhawy A. H. Outcome of catheter directed thrombolysis for popliteal or infrapopliteal acute arterial occlusion. Cardiovasc Interv Ther. 2021. Vol. 36(4). P. 498–505. doi: 10.1007/s12928-020-00702-1 DOI: https://doi.org/10.1007/s12928-020-00702-1
Holyachenko O. A., Kravchenko A. M., Golyachenko A. O., Gurianov V. G., Karol I. V. Femoropopliteal angioplasty vs open surgery for chronic limb-threatening ischemia. Wiad Lek. 2022. Vol. 75(11, pt 1). P. 2585–2588. doi: 10.36740/WLek202211105 DOI: https://doi.org/10.36740/WLek202211105
Martelli E., Federici M. Venous distal bypass should be considered as the gold standard to finally attempt limb salvage in patients with severe critical limb ischemia and diabetic foot, or under dialysis. Acta Diabetol. 2020. Vol. 57(8). P. 1019–1020. doi: 10.1007/s00592-020-01524-6 DOI: https://doi.org/10.1007/s00592-020-01524-6
Houlind K. Surgical revascularization and reconstruction procedures in diabetic foot ulceration. Diabetes Metab Res Rev. 2020. Vol. 36(Suppl 1). P. e3256. doi: 10.1002/dmrr.3256 DOI: https://doi.org/10.1002/dmrr.3256
Baig M. U., Bodle J. Thrombolytic Therapy // StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023. PMID: 32491343.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Bulletin of Social Hygiene and Health Protection Organization of Ukraine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
