Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Usefulness of Percutaneous Transluminal Angioplasty before Operative Treatment in Diabetic Foot Gangrene

당뇨병성 족부 괴저에서 수술 전 시행한 경피적 경혈관 혈관성형술의 유용성

  • Im, Chul Soon (Department of Orthopedic Surgery, Dong-A University Hospital) ;
  • Lee, Myoung Jin (Department of Orthopedic Surgery, Dong-A University Hospital) ;
  • Kang, Jung Mo (Department of Orthopedic Surgery, Dong-A University Hospital) ;
  • Cho, Young-Rak (Department of Internal Medicine, Dong-A University Hospital) ;
  • Jo, Jeong Hyun (Department of Radiology, Dong-A University Hospital) ;
  • Lee, Chan Soo (Department of Orthopedic Surgery, Dong-A University Hospital)
  • 임철순 (동아대학교병원 정형외과) ;
  • 이명진 (동아대학교병원 정형외과) ;
  • 강정모 (동아대학교병원 정형외과) ;
  • 조용락 (동아대학교병원 내과) ;
  • 조정현 (동아대학교병원 영상의학과) ;
  • 이찬수 (동아대학교병원 정형외과)
  • Received : 2017.11.06
  • Accepted : 2018.02.26
  • Published : 2018.03.15
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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 $70.0{\pm}9.6years$. 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

References

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