scholarly journals The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Burak Çildağ ◽  
Ömer Faruk Kutsi Köseoğlu
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Charcot Neuroarthropathy ◽  
Below The Knee ◽  
Limb Preservation ◽  
Significant Difference ◽  
Patients With Diabetes

Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p>0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p<0.005). Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

Safety and Efficacy of Placenta-Derived Mesenchymal Stem Cell Treatment for Diabetic Patients with Critical Limb Ischemia: A Pilot Study

2019 ◽  
Author(s):  
Jiao Wang ◽  
Xiang-Xia Zeng ◽  
Wei Cai ◽  
Zhi-Bo Han ◽  
Ling-Yan Zhu ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pilot Study ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Limb Ischemia ◽  
Walking Distance ◽  
Great Promise ◽  
Diabetic Patients ◽  
Safety And Efficacy ◽  
Significant Difference

Abstract Aim Diabetic foot has become the main cause of non-traumatic amputation. Stem cell therapy, especially mesenchymal stem cells (MSCs), holds a great promise as a therapy for diabetic foot with ischemia limb arterial disease. The aim of this pilot study is to evaluate the safety and efficacy of placenta-derived MSCs (P-MSCs) treatment for diabetic patients with critical limb ischemia (CLI). Methods Four eligible diabetic patients with CLI were consecutively enrolled in this pilot study. On the base of the standard-of-care treatment, these patients accepted P-MSCs treatment by intramuscular injection for successive 3 times at an interval of 4 weeks, and the safety and efficacy of placenta-derived MSCs (P-MSCs) treatment were evaluated. Results There were no serious adverse events during the period of P-MSCs injection and the 24-weeks follow-up period. The clinical ischemic features of patients were improved 24 weeks after P-MSCs treatment. The scores of resting pain and limb coldness significantly decreased, and pain-free walking distance significantly increased from baseline to 24 weeks after P-MSCs therapy. The resting ankle brachial index increased, but no statistically significant difference was found. The findings of magnetic resonance angiography showed the increase of collateral vessel formation in one patient, but there were no significant changes observed in the other patients. Conclusions The data in this pilot study indicated that multiple intramuscular P-MSCs injections may be a safe and effective alternative therapy for diabetic patients with CLI, and larger, placebo-controlled, perspective studies are needed to prove these results.

Use of Tapered Balloons to Recanalize Occluded Below-the-Knee Arteries in Diabetic Patients with Critical Limb Ischemia

2016 ◽  
Vol 31 ◽  
pp. 105-110
Author(s):  
Nicola Troisi ◽  
Leonardo Ercolini ◽  
Emiliano Chisci ◽  
Piefrancesco Frosini ◽  
Clara Pigozzi ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Below The Knee

scholarly journals Myocardial revascularization in diabetic patients presenting with critical limbischemia

2010 ◽  
Vol 13 (4) ◽  
pp. 25-29
Author(s):  
Ivan Ivanovich Dedov ◽  
Victor Yur'evich Kalashnikov ◽  
Konstantin Vladimirovich Melkozerov
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Critical Limb Ischemia ◽  
Myocardial Revascularization ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Preoperative Risk Assessment ◽  
Therapeutic Modalities ◽  
Optimal Drug ◽  
Patients With Diabetes

The frequency of diabetic complications remains high despite the development of improved therapeutic modalities. Macroangiopathy continues to bethe predominant complication while coronary heart disease is the main cause of mortality.This paper considers clinical features of diabetic patientswith coronary heart disease and critical limb ischemia; various aspects of optimal drug therapy, preoperative examination and diagnostics precedingvascular non-cardiac surgery; preoperative risk assessment; indications for coronary angiography and myocardial revascularization. The authors emphasizethe importance of development of algorithms for the treatment of patients with diabetes, critical limb ischemia, and coronary heart disease.

Long-Term Outcomes of Direct and Indirect Below-The-Knee Open Revascularization Based on the Angiosome Concept in Diabetic Patients with Critical Limb Ischemia

2014 ◽  
Vol 28 (4) ◽  
pp. 983-989 ◽  
Author(s):  
Anne Lejay ◽  
Yannick Georg ◽  
Elvira Tartaglia ◽  
Sébastien Gaertner ◽  
Bernard Geny ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Long Term Outcomes ◽  
Below The Knee

scholarly journals Long-Term Outcomes of Diabetic Patients With Critical Limb Ischemia Followed in a Tertiary Referral Diabetic Foot Clinic

Diabetes Care ◽  
2010 ◽  
Vol 33 (5) ◽  
pp. 977-982 ◽  
Author(s):  
L. Uccioli ◽  
R. Gandini ◽  
L. Giurato ◽  
S. Fabiano ◽  
E. Pampana ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Long Term Outcomes ◽  
Tertiary Referral ◽  
Foot Clinic

scholarly journals Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Marco Meloni ◽  
Valentina Izzo ◽  
Laura Giurato ◽  
Enrico Brocco ◽  
Michele Ferrannini ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Limb Ischemia ◽  
Major Amputation ◽  
Diabetic Patients ◽  
Hospital Outcomes ◽  
Diabetic Foot Infection ◽  
The Mean

Aim. To evaluate the prognostic role of procalcitonin (PCT) in patients with diabetic foot infection (DFI) and critical limb ischemia (CLI). Materials and Methods. The study group was composed of diabetic patients with DFI and CLI. All patients were treated according to a preset limb salvage protocol which includes revascularization, wound debridement, antibiotic therapy, and offloading. Inflammatory markers, including PCT, were evaluated at admission. Only positive values of PCT, greater than 0.5 ng/ml, were considered. Hospital outcomes were categorized as limb salvage (discharge with preserved limb), major amputation (amputation above the ankle), and mortality. Results. Eighty-six patients were included. The mean age was 67.3±11.4 years, 80.7% were male, 95.1% had type 2 diabetes, and the mean diabetes duration was 20.5±11.1 with a mean HbA1c of 67±16 mmol/mol. 66/86 (76.8%) of patients had limb salvage, 7/86 (8.1%) had major amputation, and 13/86 (15.1%) died. Patients with positive PCT baseline values in comparison to those with normal values showed a lower rate of limb salvage (30.4 versus 93.6%, p=0.0001), a higher rate of major amputation (13 versus 6.3%, p=0.3), and a higher rate of hospital mortality (56.5 versus 0%, p<0.0001). At the multivariate analysis of independent predictors found at univariate analysis, positive PCT was an independent predictor of major amputation [OR 3.3 (CI 95% 2.0-5.3), p=0.0001] and mortality [OR 4.1 (CI 95% 2.2-8.3), p<0.0001]. Discussion. Positive PCT at admission increased the risk of major amputation and mortality in hospital patients with DFI and CLI.

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