Symposium 17: The vasculopathy
DOI:
https://doi.org/10.47196/diab.v56i3Sup.596Keywords:
foot, ulcerAbstract
Diabetic foot ulcers and wound healing depend on several variables. The peripheral neuropathy, abnormal foot structure, peripheral vascular disease (PAD), inadequate glycemic control, smoking, and history of ulcers or amputations affect the wound’s evolution. (1)PAD and poor wound healing impede the resolution of small wounds, allowing these to increase in size and become infected. There is a strong association between diabetes and critical limb ischemia, which is the highest risk stage of PAD with a high risk of amputation. PAD in diabetic patients is often a multilevel disease, the involvement of infrapopliteal vessels and below the ankle (BTA) territory are characteristic.(2-3)
BTA arterial disease denotes a more aggressive pattern of PTA. The revascularization in CLI improves the pain, restores the flow to the foot, and increases the tissular perfusion to increase the chance of limb salvage. The development of new techniques impacts the new frontiers for the revascularization of BTK and BTA disease and complex lesions.
References
I. Tresierra-Ayala MA, García Rojas A. Association between peripheral arterial disease and diabetic foot ulcers in patients with diabetes mellitus type 2. Medicina Universitaria 2017;19(76):123-126
II. Graziani L, Silvestro A, Bertone V, Manara E, Andreini R, Sigala A, et al. Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur J Vasc Endovasc Surg 2007;33(4):453-60.
III. Chen Q, Shi Y, Wang Y, Li X. Patterns of disease distribution of lower extremity peripheral arterial disease. Angiology 2015 Mar 1;66(3):211-8.
IV. Špillerová K, Sörderström M, Albäck A, Venermo M. The feasibility of angiosome-targeted endovascular treatment in patients with critical limb ischemia and foot ulcer. Ann Vasc Surg 2016 Jan 1;30:270-6.
V. Settembre N, Biancari F, Spillerova K, Albäck A, Söderström M, Venermo M. Competing risk analysis of the impact of pedal arch status and angiosome-targeted revascularization in chronic limb-threatening ischemia. Ann Vasc Surg 2020;68:384-90.
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