Angiosome based revascularization for diabetic foot ulcer

Abstract

Background: The purpose of this study was to analyze the clinical benefit in wound healing and limb preservation after infrapopliteal endovascular revascularization guided by an angiosome model of perfusion in the healing process of diabetic foot ulcers.Methods: This is a prospective controlled study was conducted on 60 patients with critical lower limb ischemia in the form of diabetic foot ulcer and/or gangrene. The study period started from August 2017 until February 2019. Patients included in the study were essentially attending the Vascular Outpatient Clinic at Menoufia University Hospitals and Nasser Institute for Search and Treatment at Cairo treated by infra-popliteal angioplasty.Results: The 60 patients of our study who underwent successful infra-popliteal angioplasty we found that after six months 18 patients in the direct group A (85.71%), 9 patients in indirect group B (42.85%) and 17 patients in combined group C (94.44%) showed complete healing of their wounds and that 18 patients in group A (85.71%), 15 patients in group B (71.42%) and 17 patients in group C (94.44%) have their limbs salvaged total 50 patients (83.33%).Conclusions: We concluded that dilation of angiosome target artery plus any other significant tibial artery lesions should be considered and indirect revascularization should not be denied with acceptable result over time.