Our Attempt for Diabetic Foot Management With Infrapopliteal Artery Angiosome Revascularization

Objectives: 15%–25% of DM patients develop diabetic foot. Methods: Diabetic patients Wifi 3–4 with CLTI (n = 35): Men 25 (71.4%), women 10 (28.6%); average age – 68 years, selected with adequate inflow to the popliteal artery, as defined by presence of one of the following:

Palpable ipsilateral popliteal artery pulse Biphasic or triphasic Doppler waveform in the ipsilateral popliteal artery Normal radiographic appearance of ipsilateral common femoral and arteria profunda femoris or all detected lesions are <50% severity stenosis.

Results: In Group I (angiosomal revascularization) of 16 patients in 2 (12.5%) repeated interventions were performed. Of these, 1 (6.25%) eventually had a high amputation. In Group II (nondirect angiosome revascularization) of 16 patients in 5 (31.25%) repeated interventions were performed. Of these, 4 (25%) eventually had a high amputation and 1 (20%) had healing of trophic disorders. In Group III (nonangiosomal revascularization), out of 3 patients, in 1 (33%) twice there were repeated interventions, finally high amputation was performed, in 1 (33%)-healing of trophic disorders within 2 months, in 1 (33%)-trophic disorders did not heal (after 2 months after surgery the death for other reasons). Conclusion: The angiosomal concept does not provide an exact answer regarding the role of each of the main arteries in the blood supply to the shin and limb. If it is impossible to follow to the angiosomal principle, we should try to restore blood flow to any trunk artery.

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Artikel online veröffentlicht:
26. April 2021