[Endovascular Revascularization for Diabetic Foot Ulcer - Experience from a Dedicated Clinic].

Autor:	da Silva S; Serviço de Cirurgia Geral, Centro Hospitalar do Tâmega e Sousa EPE, Portugal., Vasconcelos J; Serviço de Angiologia e Cirurgia Vascular Centro Hospitalar do Tâmega e Sousa EPE; Consulta Multidisciplinar de Pé Diabético, Portugal., Maia M; Serviço de Angiologia e Cirurgia Vascular Centro Hospitalar do Tâmega e Sousa EPE; Consulta Multidisciplinar de Pé Diabético, Portugal., Vidoedo JC; Serviço de Angiologia e Cirurgia Vascular Centro Hospitalar do Tâmega e Sousa EPE; Consulta Multidisciplinar de Pé Diabético, Portugal., Dantas MJ; Serviço de Cirurgia Geral, Centro Hospitalar do Tâmega e Sousa EPE; Consulta Multidisciplinar de Pé Diabético, Portugal., Cruz A; Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar do Tâmega e Sousa EPE, Portugal., Almeida Pinto J; Serviço de Angiologia e Cirurgia Vascular Centro Hospitalar do Tâmega e Sousa EPE; Consulta Multidisciplinar de Pé Diabético, Portugal.
Jazyk:	portugalština
Zdroj:	Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular [Rev Port Cir Cardiotorac Vasc] 2016 Jan-Jun; Vol. 23 (1-2), pp. 55-62.
Abstrakt:	Objectives: We aimed to assess the outcome of endovascular revascularization in Diabetic patients with Fontaine stage IV chronic ischaemia, at our Diabetic Foot Clinic. Primary outcomes were ulcer healing, major amputation and limb salvage. Methods: Retrospective single center analysis of patients treated between January 2009 and May 2015. Time-dependent event rates were estimated by the Kaplan-Meier method. The differences between groups were evaluated with the chi-square test. A P value below 0,05 was considered statistically significant. Results: There were 106 limbs (93 patients) revascularized during the study. The average age was 71 years, and PEDIS 3 or 4 infection was present in 45.3% on admission. 56.6% were treated for femoropopliteal injurie only, 17% infrapopliteal, and 26.4% for both levels. Technical success was achieved in 77.4%, and haemodynamic success in 58.3%. Ulcer healing was attained in 53.8%, with an average healing time of 8.4 months. The major amputation rate was 7.5%, with a limb salvage rate of 90.4% at 6, 12 and 24 months. Chronic pulmo- nary disease decreased the likelihood of healing (p=0,012). Restenosis was more likely to occur in patients with nephropathy (p=0,008) or insulin-treated diabetes (p=0,033). Conclusions: Dedicated multidisciplinary teams are key to successful treatment in diabetic foot disease. The good results achieved in our series arise from best medical treatment combined with timely revascularization in those ischemic.
Databáze:	MEDLINE
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