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CardioVascular and Interventional Radiology

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01-06-2013 | Clinical Investigation

Endovascular Treatment of Diabetic Foot in a Selected Population of Patients with Below-the-Knee Disease: Is the Angiosome Model Effective?

Authors: Rita Fossaceca, Giuseppe Guzzardi, Paolo Cerini, Claudio Cusaro, Alessandro Stecco, Giuseppe Parziale, Marco Perchinunno, Marco De Bonis, Alessandro Carriero

Published in: CardioVascular and Interventional Radiology | Issue 3/2013

Abstract

Purpose

To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in a selected population of diabetic patients with below-the-knee (BTK) disease and to analyze the reliability of the angiosome model.

Methods

We made a retrospective analysis of the results of PTA performed in 201 diabetic patients with BTK-only disease treated at our institute from January 2005 to December 2011. We evaluated the postoperative technical success, and at 1, 6, and 12 months’ follow-up, we assessed the rates and values of partial and complete ulcer healing, restenosis, major and minor amputation, limb salvage, and percutaneous oximetry (TcPO₂) (Student’s t test). We used the angiosome model to compare different clinicolaboratory outcomes in patients treated by direct revascularization (DR) from patients treated with indirect revascularization (IR) technique by Student’s t test and the χ² test.

Results

At a mean ± standard deviation follow-up of 17.5 ± 12 months, we observed a mortality rate of 3.5 %, a major amputation rate of 9.4 %, and a limb salvage rate of 87 % with a statistically significant increase of TcPO₂ values at follow-up compared to baseline (p < 0.05). In 34 patients, treatment was performed with the IR technique and in 167 by DR; in both groups, there was a statistically significant increase of TcPO₂ values at follow-up compared to baseline (p < 0.05), without statistically significant differences in therapeutic efficacy.

Conclusion

PTA of the BTK-only disease is a safe and effective option. The DR technique is the first treatment option; we believe, however, that IR is similarly effective, with good results over time.

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Title: Endovascular Treatment of Diabetic Foot in a Selected Population of Patients with Below-the-Knee Disease: Is the Angiosome Model Effective?
Authors: Rita Fossaceca
Giuseppe Guzzardi
Paolo Cerini
Claudio Cusaro
Alessandro Stecco
Giuseppe Parziale
Marco Perchinunno
Marco De Bonis
Alessandro Carriero
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 3/2013
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-012-0544-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endovascular Treatment of Diabetic Foot in a Selected Population of Patients with Below-the-Knee Disease: Is the Angiosome Model Effective?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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