Department of Plastic and Reconstructive Surgery, Kangwon National University Hospital, Chuncheon, Korea.
Department of Plastic and Reconstructive Surgery, Kangwon National University School of Medicine, Chuncheon, Korea.
Wounds. 2023 Aug;35(8):E261-E264. doi: 10.25270/wnds/23046.
PAD frequently co-occurs with diabetes, often leading to chronic nonhealing wounds. Foot gangrene and amputation are common outcomes of untreated CLI.
A 67-year-old male with diabetes and deteriorating limb ischemia following surgical stress underwent successful surgical repair after emergency PTA of the SFA for extensive heel necrosis. After surgical debridement of necrotic heel tissue, the ABI on the affected side suddenly reduced to 0.36, but it improved to 1.06 at 4 weeks following stenting angioplasty, allowing the subsequent flap surgery to repair the heel defect. At the 1-year follow-up visit, the patient exhibited durable heel coverage and the restoration of weightbearing function. No signs or symptoms indicative of restenosis were evident in the blood vessel treated with stent angioplasty.
This case highlights the importance of proper evaluation of critical ischemic conditions and the need for prompt endovascular interventions in preserving the at-risk diabetic foot.
PAD 常与糖尿病同时发生，常导致慢性难愈性创面。未经治疗的 CLI 常导致足部坏疽和截肢。
一位 67 岁男性，因手术应激导致糖尿病和肢体缺血恶化，在 SFA 行紧急 PTA 后成功修复了广泛足跟坏死。足跟坏死组织行外科清创后，患侧 ABI 突然降至 0.36，但支架血管成形术后 4 周时升至 1.06，随后行皮瓣手术修复足跟缺损。1 年随访时，患者足跟覆盖持久，负重功能恢复。支架血管成形术治疗的血管未见再狭窄的迹象或症状。
本病例强调了正确评估临界缺血情况的重要性，以及及时进行血管内介入治疗以保留高危糖尿病足的必要性。
