The short- and long-term results of therapy of surgical diabetic foot patients

Abstract

Introduction. The arterial limb threating is the leading cause of non-traumatic amputations in diabetic foot patients. The breakthrough in the treatment of this group of patients was the widespread introduction of transluminal balloon angioplasty (TLBA) of the arteries of the lower extremities.Aim. To evaluate the results of the surgical treatment of the patients with diabetic neuro ischemic foot syndrome according the data of Government Center of Limb Salvation in 2022–2023 years.Materials and methods. The study presents a retrospective analysis of medical documentations and the results of a survey one year after discharge from the hospital of 180 patients.Results. The arterial limb threating is observed in equal frequency in both men with diabetes and women at a relatively young age (66.0 ± 12.8 years). The glycemic control in most patients is above the target values. Various groups of sugar-lowering drugs are widely used. More than a third of patients with CKD suffer from CKD with GFR less than 60 ml/min, however inSGLT-2 are used in slightly more than 15% of cases. The damages of the lower extremities arteries below the knee are observed in the most of cases. Every third patient has the occlusion/hemodynamically significant stenosis of the femoral and tibia arteries. The method of choosing revascularization is TLBA the lower extremities arteries without stenting, hybrid operations are performed in up to 10% of cases in the hospital. During the first year of follow up the 21.2% of the patients have recurrences of the ischemic tissue lesions of the feet including revascularization. The recurrences of the ischemic tissue lesions of the feet after surgical approach are revealed in 9% cases only. There are TLBA in all other cases. The mortality rate is 9.6 cases per 100 patients per year.Conclusion. The patients after revascularization for the neuro-ischemic diabetic foot tissue loss and limb salvage remain at high risk of both mortality and recurrence of arterial limb threating in the early and delayed follow up.