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Usefulness of Percutaneous Transluminal Angioplasty before Operative Treatment in Diabetic Foot Gangrene
J Korean Foot Ankle Soc 2018;22:32-37
Published online March 15, 2018;  https://doi.org/10.14193/jkfas.2018.22.1.32
© 2018 Korean Foot and Ankle Society

Chul Soon Im, Myoung Jin Lee, Jung Mo Kang, Young-Rak Cho*, Jeong Hyun Jo, Chan Soo Lee

Departments of Orthopedic Surgery, *Internal Medicine, and Radiology, Dong-A University Hospital, Busan, Korea
Correspondence to: Myoung Jin Lee
Department of Orthopedic Surgery, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea
Tel: 82-51-240-5166, Fax: 82-51-254-6757, E-mail: tynitus@dau.ac.kr
ORCID: http://orcid.org/0000-0002-4388-7196
Received November 6, 2017; Revised February 14, 2018; Accepted February 26, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome.
Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was 70.0±9.6 years. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period.
Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation).
Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.
Keywords : Diabetic foot, Angioplasty, Gangrene


March 2018, 22 (1)