Seliga P, Vasko J, Kovác P, Simko M
Oddelenie cievnej chirurgie FNsP Presov, Slovenská republika.
Rozhl Chir. 2009 Aug;88(8):444-50.
The authors analyse the patients hospitalized with a neuroischemic diabetic foot. They evaluate experiences and results of the crural arteries percutaneous transluminal angioplasty (PTA) in the diabetic patients.
It is a retrospective analysis of the patients hospitalized during years 2005-2008 at the Department of Vascular Surgery of the Teaching Hospital J. A. Reiman Presov with the diabetic foot. During the study period 265 hospitalization in 205 patients were registered for complications of the diabetic foot. PTA of the crural arteries was performed on 74 lower extremities in 68 patients. 133 crural arteries were revascularized in this group of the patients. Indication for execution of the crural arteries PTA in the diabetic patients was critical limb ischemia on 68 revascularized lower extremities (91.9%).
Technical success (residual stenosis no more than 30%, unobstructed revascularized crural artery to periphery) was achieved on 93 revascularized crural arteries (69.92%). They have control examination minimally 12 months after PTA in 54 revascularized lower extremities of the 68 patients with the neuroischemic diabetic foot. From this subset of the patients 28 lower extremities (51.85%) are healed according to clinical examination, on 7 lower extremities (12.96%) clinical signs of critical limb ischemia remain, 10 times (18.52%) low amputation was performed and 9 times (16.67%) high amputation was executed.
The authors believe that PTA of the crural arteries is safe and effective method of critically ischemic diabetic foot revascularization. If revascularization is successful, it can effectively contributes to the lower extremity salvage of the patient with neuroischemic diabetic foot.
作者分析因神经缺血性糖尿病足住院的患者。他们评估糖尿病患者腘动脉经皮腔内血管成形术(PTA)的经验和结果。
这是一项对2005年至2008年期间在雅罗斯拉夫·雷曼教学医院血管外科住院的糖尿病足患者的回顾性分析。在研究期间,登记了205例患者的265次因糖尿病足并发症的住院情况。对68例患者的74条下肢进行了腘动脉PTA。该组患者中有133条腘动脉实现了血运重建。糖尿病患者进行腘动脉PTA的指征是68条血运重建的下肢存在严重肢体缺血(91.9%)。
93条血运重建的腘动脉(69.92%)实现了技术成功(残余狭窄不超过30%,血运重建的腘动脉至外周通畅)。对68例神经缺血性糖尿病足患者中54条血运重建下肢的患者在PTA后至少12个月进行了对照检查。在该亚组患者中,根据临床检查,28条下肢(51.85%)愈合,7条下肢(12.96%)仍有严重肢体缺血的临床体征,进行了10次(18.52%)低位截肢和9次(16.67%)高位截肢。
作者认为,腘动脉PTA是严重缺血性糖尿病足血运重建的安全有效方法。如果血运重建成功,它可以有效地有助于神经缺血性糖尿病足患者下肢的挽救。