Managing Peripheral Artery Disease in Diabetic Patients: A Questionnaire Survey from Vascular Centers of the Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS)
| Autor: | G Bajardi, Francesco Setacci, Emad Hussein, Giancarlo Bracale, Olivier Goëau-Brissonnière, Ben R. Saleem, E Dinoto, Liborio Ferrante, Jamal J. Hoballah, Gianmarco de Donato, Maurizio Taurino, Bruno Gossetti, F Pecoraro, Bianca Pane, Anna Giribono, Raffaele Pulli, Vincenzo De Luca, Tarek Sraieb, Carlo Setacci, Andrea Stella, Umberto Bracale, Matteo Tozzi, Raffaele Pio Ammollo, Mohamed N. Bouayed, Patrizio Castelli, Maddalena Illario |
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| Přispěvatelé: | Bracale U.M., Ammollo R.P., Hussein E.A., Hoballah J.J., Goeau-Brissonniere O., Taurino M., Setacci C., Pecoraro F., Bracale G., Giribono A.M., Ferrante L., de Donato G., Dinoto E., Bajardi G., Illario M., Bouayed M.N., Saleem B.R., Pulli R., Gossetti B., Pane B., Castelli P., Tozzi M., Sraieb T., Setacci F., Stella A., De Luca V., Bracale, Umberto Marcello, Ammollo, Raffaele Pio, Hussein, Emad A, Hoballah, Jamal J, Goeau-Brissonniere, Olivier, Taurino, Maurizio, Setacci, Carlo, Pecoraro, Felice, Bracale, Giancarlo |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_treatment
Psychological intervention 030204 cardiovascular system & hematology vascular surgery Settore MED/22 - Chirurgia Vascolare 030218 nuclear medicine & medical imaging Wound care 0302 clinical medicine Ischemia Practice Patterns Physicians' Response rate (survey) Practice Patterns Nurses' diabetes Mediterranean Region Endovascular Procedures vascular medicine General Medicine Treatment Outcome Cardiology and Cardiovascular Medicine Vascular Surgical Procedures diabetic foot management Specialization Reoperation medicine.medical_specialty Revascularization Nurse's Role Amputation Surgical 03 medical and health sciences peripheral arterial disease Mediterranean Sea medicine Humans Training Healthcare Disparities Endovascular Surgery Vascular Surgery Physician's Role Patient Care Team Wound Healing business.industry General surgery Vascular surgery medicine.disease Diabetic foot Amputation Health Care Surveys Orthopedic surgery Surgery business wound care |
| Zdroj: | Annals of Vascular Surgery. 64:239-245 |
| ISSN: | 0890-5096 |
| Popis: | Background The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded on October 1, 2018, to enhance cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic arteriopathy has been selected as the very first topic to be investigated by the federation. Methods MeFAVS members were asked to reply to a questionnaire on the management of diabetic ischemic foot. Results were collected and analyzed statistically. The questionnaire consisted of 15 multiple choice answers regarding diabetic foot (DF) diagnosis and treatment. The questionnaire was submitted to 21 centers on April 20, 2019. Results Response rate was 62%. The survey revealed that vascular surgeons, diabetologists, and wound care nurses made-up the core of the diabetic teams present in 76.9%, 69.3%, and 92.3% of the centers, respectively. Diabetic teams were most often led by vascular surgeons (53.8%) and diabetologists (42.2%), but only in 7.9% of cases by nurses. Duplex ultrasonography and computed tomographic angiography were the most commonly available tools used to assess diabetic peripheral arterial disease (PAD). Surgical wound care was undertaken by vascular surgeons in the majority of cases, and only in 46.2% of the cases to orthopedic or plastic surgeons, while nonsurgical wound care was handled by specialized nurses (76.6%) and diabetologists (53.8%). First-line revascularization was preferred over conservative treatment (61.5% vs 53.8%) and endovascular strategy (45.3%) over open (33.7%) or hybrid (21.0%) surgery. Vascular surgeons and interventional radiologists were found to be the most common performers of endovascular revascularization (92.3% and 53.8%, respectively). Amputations had an overall rate of 16.6% (range 4–30%) and a mean reintervention rate of 22.5%, and were usually performed by vascular surgeons for both minor and major interventions (84.6%) followed by orthopedic surgeons (15.4% minor and 30.8% major). The availability of a DF clinic (84.6%) and endovascular (53.8%) and open surgery (46.2%) capabilities were considered fundamental to reduce amputation rates. Conclusions Especially since the introduction and spreading of new endovascular techniques for the treatment of DF, it is a common consensus amongst vascular surgeons that a standardized approach to the discipline is necessary in order to improve outcomes such as amputation-free survival and mortality and it is with this perspective and purpose that transnational cooperation amongst vascular professionals and residents in training are aiming for greater proficiency in endovascular and open surgery. |
| Databáze: | OpenAIRE |
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