The role of a specialized approach for patients with diabetes, critical ischaemia and foot ulcers not previously considered for proactive management
Diabet. Med. 28, 1249–1252 (2011) Aims To analyse the outcome of the proactive management of patients with diabetes, critical limb ischaemia and foot ulcers using percutaneous transluminal angioplasty as the only vascular procedure and adjuvant conservative surgery when indicated. Methods A retros...
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| Veröffentlicht in: | Diabetic medicine 2011-10, Vol.28 (10), p.1249-1252 |
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| creator | Aragón-Sánchez, J. Maynar-Moliner, M. Pulido-Duque, J. M. Rabellino, M. González, G. Zander, T. |
| description | Diabet. Med. 28, 1249–1252 (2011)
Aims To analyse the outcome of the proactive management of patients with diabetes, critical limb ischaemia and foot ulcers using percutaneous transluminal angioplasty as the only vascular procedure and adjuvant conservative surgery when indicated.
Methods A retrospective study of patients with diabetes included in our database who sought a second opinion in our unit and met the following criteria: foot ulcer and critical limb ischaemia in patients for whom any proactive vascular treatment had not previously been considered by other teams.
Results Twenty patients underwent endovascular procedures. Success was achieved in 19 cases (95%). No post‐operative mortality (within 30 days after the procedure) was found. Additional surgery was required in eight cases (40%): one calcaneal ostectomy and seven minor amputations. The need for surgery was associated with infection (P |
| doi_str_mv | 10.1111/j.1464-5491.2011.03367.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_892945432</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>892945432</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3877-5cb0fbca8b298468415abf91cff5a6bc96ead767264e671cffb75dbfeec2bf053</originalsourceid><addsrcrecordid>eNpFUUuP0zAQjhCILQt_AfmCuJBgO3acHDiwZR9Iu3BZQOJijZ0JdckLO91t93fwg3FoKb545O8x4_mShDCasXjerjMmCpFKUbGMU8YymueFyraPksUReJwsqBI8zaliJ8mzENaUMl7l1dPkhLOi4qXIF8nv2xUSP7RIhoYACSNaB617wJrAOPoB7Io0gycjTA77KZB7N61I7cDghOENsd5NzkJLXLArwM4Bgb6OkmEim9aiD6SP5ejxzg2b0O6IHfrgavRY743nHpO7Q9JBDz-wi12eJ08aaAO-ONynyZeL89vlVXr9-fLj8v11avNSqVRaQxtjoTS8KkVRCibBNBWzTSOhMLYqEGpVKF4ILNT8bJSsTYNouWmozE-T13vfOMSvDYZJd_Eb2LbQYxxWlxWvhBQ5j8yXB-bGdFjr0bsO_E7_W2QkvDoQIMR1NB5668J_npCSKj4bvdvz7l2LuyPOqJ6D1Ws956fn_PQcrP4brN7qDzfncxX16V7vwoTbox78Tx1RJfW3T5daLG-qC_X1uz7L_wBeyql6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>892945432</pqid></control><display><type>article</type><title>The role of a specialized approach for patients with diabetes, critical ischaemia and foot ulcers not previously considered for proactive management</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Aragón-Sánchez, J. ; Maynar-Moliner, M. ; Pulido-Duque, J. M. ; Rabellino, M. ; González, G. ; Zander, T.</creator><creatorcontrib>Aragón-Sánchez, J. ; Maynar-Moliner, M. ; Pulido-Duque, J. M. ; Rabellino, M. ; González, G. ; Zander, T.</creatorcontrib><description>Diabet. Med. 28, 1249–1252 (2011)
Aims To analyse the outcome of the proactive management of patients with diabetes, critical limb ischaemia and foot ulcers using percutaneous transluminal angioplasty as the only vascular procedure and adjuvant conservative surgery when indicated.
Methods A retrospective study of patients with diabetes included in our database who sought a second opinion in our unit and met the following criteria: foot ulcer and critical limb ischaemia in patients for whom any proactive vascular treatment had not previously been considered by other teams.
Results Twenty patients underwent endovascular procedures. Success was achieved in 19 cases (95%). No post‐operative mortality (within 30 days after the procedure) was found. Additional surgery was required in eight cases (40%): one calcaneal ostectomy and seven minor amputations. The need for surgery was associated with infection (P < 0.01). Limb salvage was sustained during a mean period of follow‐up of 642 days (sd 488) in 19 cases (95%). Healing was achieved in 14 cases (70%), four are still healing (20%), one underwent major amputation (5%) and the last one died before being healed (5%). Three patients died during follow‐up (15%).
Conclusions Management of patients with diabetes, foot ulcers and critical limb ischaemia by means of a proactive approach including endovascular procedures in specialized settings provides a high rate of limb salvage. This may result in lowering the number of lower limb amputations in our community.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/j.1464-5491.2011.03367.x</identifier><identifier>PMID: 21692843</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Amputation - statistics & numerical data ; Angioplasty ; Biological and medical sciences ; critical limb ischaemia ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - physiopathology ; Diabetes. Impaired glucose tolerance ; Diabetic Angiopathies - physiopathology ; Diabetic Angiopathies - therapy ; diabetic foot ; Diabetic Foot - physiopathology ; Diabetic Foot - therapy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Female ; foot ulcer ; Fundamental and applied biological sciences. Psychology ; Humans ; Ischemia - etiology ; Ischemia - physiopathology ; Ischemia - therapy ; Limb Salvage ; Male ; Medical sciences ; percutaneous transluminal angioplasty ; peripheral arterial disease ; Peripheral Vascular Diseases - complications ; Peripheral Vascular Diseases - physiopathology ; Peripheral Vascular Diseases - therapy ; Retrospective Studies ; Treatment Outcome ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Wound Healing</subject><ispartof>Diabetic medicine, 2011-10, Vol.28 (10), p.1249-1252</ispartof><rights>2011 The Authors. Diabetic Medicine © 2011 Diabetes UK</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3877-5cb0fbca8b298468415abf91cff5a6bc96ead767264e671cffb75dbfeec2bf053</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-5491.2011.03367.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-5491.2011.03367.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24550722$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21692843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aragón-Sánchez, J.</creatorcontrib><creatorcontrib>Maynar-Moliner, M.</creatorcontrib><creatorcontrib>Pulido-Duque, J. M.</creatorcontrib><creatorcontrib>Rabellino, M.</creatorcontrib><creatorcontrib>González, G.</creatorcontrib><creatorcontrib>Zander, T.</creatorcontrib><title>The role of a specialized approach for patients with diabetes, critical ischaemia and foot ulcers not previously considered for proactive management</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Diabet. Med. 28, 1249–1252 (2011)
Aims To analyse the outcome of the proactive management of patients with diabetes, critical limb ischaemia and foot ulcers using percutaneous transluminal angioplasty as the only vascular procedure and adjuvant conservative surgery when indicated.
Methods A retrospective study of patients with diabetes included in our database who sought a second opinion in our unit and met the following criteria: foot ulcer and critical limb ischaemia in patients for whom any proactive vascular treatment had not previously been considered by other teams.
Results Twenty patients underwent endovascular procedures. Success was achieved in 19 cases (95%). No post‐operative mortality (within 30 days after the procedure) was found. Additional surgery was required in eight cases (40%): one calcaneal ostectomy and seven minor amputations. The need for surgery was associated with infection (P < 0.01). Limb salvage was sustained during a mean period of follow‐up of 642 days (sd 488) in 19 cases (95%). Healing was achieved in 14 cases (70%), four are still healing (20%), one underwent major amputation (5%) and the last one died before being healed (5%). Three patients died during follow‐up (15%).
Conclusions Management of patients with diabetes, foot ulcers and critical limb ischaemia by means of a proactive approach including endovascular procedures in specialized settings provides a high rate of limb salvage. This may result in lowering the number of lower limb amputations in our community.</description><subject>Aged</subject><subject>Amputation - statistics & numerical data</subject><subject>Angioplasty</subject><subject>Biological and medical sciences</subject><subject>critical limb ischaemia</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Angiopathies - physiopathology</subject><subject>Diabetic Angiopathies - therapy</subject><subject>diabetic foot</subject><subject>Diabetic Foot - physiopathology</subject><subject>Diabetic Foot - therapy</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>foot ulcer</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Ischemia - etiology</subject><subject>Ischemia - physiopathology</subject><subject>Ischemia - therapy</subject><subject>Limb Salvage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>percutaneous transluminal angioplasty</subject><subject>peripheral arterial disease</subject><subject>Peripheral Vascular Diseases - complications</subject><subject>Peripheral Vascular Diseases - physiopathology</subject><subject>Peripheral Vascular Diseases - therapy</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><subject>Wound Healing</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFUUuP0zAQjhCILQt_AfmCuJBgO3acHDiwZR9Iu3BZQOJijZ0JdckLO91t93fwg3FoKb545O8x4_mShDCasXjerjMmCpFKUbGMU8YymueFyraPksUReJwsqBI8zaliJ8mzENaUMl7l1dPkhLOi4qXIF8nv2xUSP7RIhoYACSNaB617wJrAOPoB7Io0gycjTA77KZB7N61I7cDghOENsd5NzkJLXLArwM4Bgb6OkmEim9aiD6SP5ejxzg2b0O6IHfrgavRY743nHpO7Q9JBDz-wi12eJ08aaAO-ONynyZeL89vlVXr9-fLj8v11avNSqVRaQxtjoTS8KkVRCibBNBWzTSOhMLYqEGpVKF4ILNT8bJSsTYNouWmozE-T13vfOMSvDYZJd_Eb2LbQYxxWlxWvhBQ5j8yXB-bGdFjr0bsO_E7_W2QkvDoQIMR1NB5668J_npCSKj4bvdvz7l2LuyPOqJ6D1Ws956fn_PQcrP4brN7qDzfncxX16V7vwoTbox78Tx1RJfW3T5daLG-qC_X1uz7L_wBeyql6</recordid><startdate>201110</startdate><enddate>201110</enddate><creator>Aragón-Sánchez, J.</creator><creator>Maynar-Moliner, M.</creator><creator>Pulido-Duque, J. M.</creator><creator>Rabellino, M.</creator><creator>González, G.</creator><creator>Zander, T.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201110</creationdate><title>The role of a specialized approach for patients with diabetes, critical ischaemia and foot ulcers not previously considered for proactive management</title><author>Aragón-Sánchez, J. ; Maynar-Moliner, M. ; Pulido-Duque, J. M. ; Rabellino, M. ; González, G. ; Zander, T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3877-5cb0fbca8b298468415abf91cff5a6bc96ead767264e671cffb75dbfeec2bf053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Amputation - statistics & numerical data</topic><topic>Angioplasty</topic><topic>Biological and medical sciences</topic><topic>critical limb ischaemia</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Angiopathies - physiopathology</topic><topic>Diabetic Angiopathies - therapy</topic><topic>diabetic foot</topic><topic>Diabetic Foot - physiopathology</topic><topic>Diabetic Foot - therapy</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>foot ulcer</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Ischemia - etiology</topic><topic>Ischemia - physiopathology</topic><topic>Ischemia - therapy</topic><topic>Limb Salvage</topic><topic>Male</topic><topic>Medical sciences</topic><topic>percutaneous transluminal angioplasty</topic><topic>peripheral arterial disease</topic><topic>Peripheral Vascular Diseases - complications</topic><topic>Peripheral Vascular Diseases - physiopathology</topic><topic>Peripheral Vascular Diseases - therapy</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aragón-Sánchez, J.</creatorcontrib><creatorcontrib>Maynar-Moliner, M.</creatorcontrib><creatorcontrib>Pulido-Duque, J. M.</creatorcontrib><creatorcontrib>Rabellino, M.</creatorcontrib><creatorcontrib>González, G.</creatorcontrib><creatorcontrib>Zander, T.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aragón-Sánchez, J.</au><au>Maynar-Moliner, M.</au><au>Pulido-Duque, J. M.</au><au>Rabellino, M.</au><au>González, G.</au><au>Zander, T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of a specialized approach for patients with diabetes, critical ischaemia and foot ulcers not previously considered for proactive management</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2011-10</date><risdate>2011</risdate><volume>28</volume><issue>10</issue><spage>1249</spage><epage>1252</epage><pages>1249-1252</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>Diabet. Med. 28, 1249–1252 (2011)
Aims To analyse the outcome of the proactive management of patients with diabetes, critical limb ischaemia and foot ulcers using percutaneous transluminal angioplasty as the only vascular procedure and adjuvant conservative surgery when indicated.
Methods A retrospective study of patients with diabetes included in our database who sought a second opinion in our unit and met the following criteria: foot ulcer and critical limb ischaemia in patients for whom any proactive vascular treatment had not previously been considered by other teams.
Results Twenty patients underwent endovascular procedures. Success was achieved in 19 cases (95%). No post‐operative mortality (within 30 days after the procedure) was found. Additional surgery was required in eight cases (40%): one calcaneal ostectomy and seven minor amputations. The need for surgery was associated with infection (P < 0.01). Limb salvage was sustained during a mean period of follow‐up of 642 days (sd 488) in 19 cases (95%). Healing was achieved in 14 cases (70%), four are still healing (20%), one underwent major amputation (5%) and the last one died before being healed (5%). Three patients died during follow‐up (15%).
Conclusions Management of patients with diabetes, foot ulcers and critical limb ischaemia by means of a proactive approach including endovascular procedures in specialized settings provides a high rate of limb salvage. This may result in lowering the number of lower limb amputations in our community.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21692843</pmid><doi>10.1111/j.1464-5491.2011.03367.x</doi><tpages>4</tpages></addata></record> |
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| subjects | Aged Amputation - statistics & numerical data Angioplasty Biological and medical sciences critical limb ischaemia Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - physiopathology Diabetes. Impaired glucose tolerance Diabetic Angiopathies - physiopathology Diabetic Angiopathies - therapy diabetic foot Diabetic Foot - physiopathology Diabetic Foot - therapy Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Female foot ulcer Fundamental and applied biological sciences. Psychology Humans Ischemia - etiology Ischemia - physiopathology Ischemia - therapy Limb Salvage Male Medical sciences percutaneous transluminal angioplasty peripheral arterial disease Peripheral Vascular Diseases - complications Peripheral Vascular Diseases - physiopathology Peripheral Vascular Diseases - therapy Retrospective Studies Treatment Outcome Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Wound Healing |
| title | The role of a specialized approach for patients with diabetes, critical ischaemia and foot ulcers not previously considered for proactive management |
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