scholarly journals Medical Management of Peripheral Artery Disease in Patient with Diabetic Foot Ulcer: A Case Report

2017 ◽  
Vol 03 (01) ◽  
Author(s):  
Aderemilekun I. Babatunde
Keyword(s):  
Case Report ◽  
Peripheral Artery Disease ◽  
Diabetic Foot ◽  
Medical Management ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Peripheral Artery ◽  
Artery Disease

The Neuro-Vascular Consequence of Diabetes: Foot Amputation and Evaluation of its Risk Factors and Health-Related Economic Impact

2020 ◽  
Vol 19 (1) ◽  
pp. 102-109
Author(s):  
Iftikhar Haider Naqvi ◽  
Abu Talib ◽  
Sajjad Haider Naqvi ◽  
Lubabah Yasin ◽  
Nayema Zehra Rizvi
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Peripheral Artery Disease ◽  
Diabetic Foot ◽  
Financial Burden ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Peripheral Artery ◽  
Health Related ◽  
Artery Disease

Background: The rising prevalence of type 2 diabetes mellitus (T2DM) with the huge burden of diabetic foot amputation is a challenge to the health economy of Pakistan and other countries. Identification of various risk factors for amputation, along with its financial burden, is needed to address this problem. Objectives: This study aimed to determine the financial burden and risk factors associated with T2DMrelated foot amputation. Methods: Retrospective hospital-based study from January 2017 to December 2018. Patients with T2DM with and without amputation were enrolled. The direct medical costs of amputation along with various risk factors, were determined. Risk factors were evaluated by logistic regression analysis. Results: A total of 1460 patients with T2DM were included; 484 (33%) patients had an amputation. The mean total cost of below knee, fingers and toe amputation was 886.63±23.91, 263.35 ±19.58 and 166.68 ± 8.47 US$, respectively. This difference among groups was significant (p<0.0001). Male gender (odds ratio, OR: 1.29, 1.01-1.63, p=0.037), peripheral artery disease (OR: 1.93, 1.52-2.46, p=0.000), peripheral neuropathy (OR: 1.31, 1.40-1.63, p=0.000), prior diabetic foot ulcer (OR: 2.02, 1.56- 2.56, p=0.000) and raised glycated haemoglobin (HbA1c) (OR: 3.50, 2.75-4.4, p=0.000) were risk factors for amputation. Conclusion: The health-related financial impact of amputations is high. Peripheral artery disease, peripheral neuropathy, prior diabetic foot ulcer and raised HbA1c were risk factors for amputation.

Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia

2017 ◽  
Vol 11 ◽  
pp. S583-S587 ◽  
Author(s):  
Rafael Henrique Rodrigues Costa ◽  
Natália Anício Cardoso ◽  
Ricardo Jayme Procópio ◽  
Túlio Pinho Navarro ◽  
Alan Dardik ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Mortality Rates ◽  
Advanced Age ◽  
Peripheral Artery ◽  
Artery Disease

Multi-Level Lower Extremity Arterial Revascularization Via Retrograde Pedal Access Under Local Anesthesia in a Patient With Severe Cardiopulmonary Comorbidities: A Case Report

2021 ◽  
pp. 153857442110264
Author(s):  
Hee Korleski ◽  
Laura DiChiacchio ◽  
Luiz Araujo ◽  
Michael R. Hall
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Peripheral Artery Disease ◽  
Critical Limb Ischemia ◽  
Treatment Modality ◽  
Conventional Treatment ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Endovascular Revascularization ◽  
Artery Disease

Background: Chronic limb-threatening ischemia is a severe form of peripheral artery disease that leads to high rates of amputation and mortality if left untreated. Bypass surgery and antegrade endovascular revascularization through femoral artery access from either side are accepted as conventional treatment modalities for critical limb ischemia. The retrograde pedal access revascularization is an alternative treatment modality useful in specific clinical scenarios; however, these indications have not been well described in literature. This case report highlights the use of retrograde pedal access approach as primary treatment modality in a patient with an extensive comorbidities precluding general anesthesia nor supine positioning. Case Presentation: The patient is a 60-year-old female with multiple severe cardiopulmonary comorbidities presenting with dry gangrene of the right great toe. Her comorbidities and inability to tolerate supine positioning precluded her from receiving open surgery, general anesthesia or monitored sedation, or percutaneous femoral access. Rather, the patient underwent ankle block and retrograde endovascular revascularization via dorsalis pedis artery access without post-operative complications. Discussion: The prevalence of comorbidities related to peripheral artery disease is increasing and with it the number of patients who are not optimal candidates for conventional treatment methods for critical limb ischemia. The retrograde pedal access revascularization as initial treatment modality offers these patients an alternative limb salvaging treatment option.

The Influence of Arterial Calcification on Clinical Outcomes in Patients with Diabetic Foot Ulcer Complicated by Osteomyelitis Treated by Surgery

2021 ◽  
pp. 153473462110225
Author(s):  
Marta Carmena-Pantoja ◽  
Francisco Javier Álvaro-Afonso ◽  
Esther García-Morales ◽  
Yolanda García-Álvarez ◽  
Aroa Tardáguila-García ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Calcification ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Time To Recurrence ◽  
Artery Disease ◽  
Clinical Records

The aim of our study was to analyze the influence of radiographic arterial calcification (RAC) on clinical outcomes and wound healing in patients with diabetic foot ulcers complicated by osteomyelitis treated by surgery. We analyzed retrospectively the clinical records of 102 patients with diabetic foot osteomyelitis who underwent surgery at a specialized diabetic foot unit between January 2014 and December 2016. The clinical data of evolution until its complete epithelialization and a follow-up 1 year were reviewed, and after reviewing the radiological images, patients were classified into 2 groups: those with RAC and those without RAC. We analyzed several clinical features in both groups. The presence of RAC was associated with a greater time of healing (10.68 ± 7.24 vs 8.11 ± 4.50 weeks; P = .029) and shorter time to recurrence and reulceration (13.30 ± 9.25 vs 18.81 ± 11.63 weeks; P = .036). However, this association was not found for patients with mild and moderate peripheral artery disease (PAD), whose time of healing was 8.97 ± 4.51 weeks compared to 9.16 ± 6.39 weeks for patients without PAD; P = .864. The time of healing of diabetic foot ulcers complicated by osteomyelitis treated by surgery can be negatively affected by the presence of RAC even more than by the presence of mild and moderate ischemia. The presence of RAC may offer clinical guidance at the level of primary care though this would need thorough validation in future studies.

Abstract 24: Health Status Differences Between Early Invasive and Non Invasive Treatment Strategies in Patients With Peripheral Artery Disease: Insights From Portrait Registry

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Suveen Angraal ◽  
Vittal Hejjaji ◽  
Laith Derbas ◽  
Manesh R Patel ◽  
Jan Heyligers ◽  
...  
Keyword(s):  
Health Status ◽  
Peripheral Artery Disease ◽  
Real World ◽  
Medical Management ◽  
World Health ◽  
Peripheral Artery ◽  
Supervised Exercise ◽  
Early Revascularization ◽  
Artery Disease

Background: In patients with symptomatic peripheral artery disease (PAD), a key treatment goal is to improve their health status; their symptoms, function, and quality of life (QoL). While medical therapy with lifestyle changes is recommended in all, revascularization can be a consideration to alleviate PAD symptoms. We sought to compare the real-world impact of either treatment strategy on patients’ health status improvement. Methods: Patients with new or worsening PAD symptoms (Rutherford category 1-3), from 10 U.S. specialty vascular clinics between 2011-2015, who either underwent early revascularization (using stent, angioplasty or surgery within 3 months of enrolment) or medical management alone (statin, aspirin, cilostazol, supervised exercise therapy, risk factor (diabetes, hypertension) management) were identified from the Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) registry. The Peripheral Artery Questionnaire (PAQ) was used to assess patients’ disease-specific health status at enrollment and at 3, 6 and 12 months of follow up. The differences in PAQ overall summary scores, and each subdomain, were compared using an adjusted generalized linear model for repeated measures (Figure 1). Results: Among 797 patients (mean age of 68.6 years, 58.1% male), 226 underwent early revascularization and 571 were managed medically. At baseline, patients in the revascularization vs. medical management cohort had lower PAQ summary scores (mean ± SD; 42.6 ± 20.7 vs. 48.5 ± 22.3, P<0.001) and QoL scores (43.4 ± 23.9 vs. 50.4 ± 26.4, P<0.001). Over 1 year of follow-up, patients who underwent revascularization reported significantly higher health status over time than patients managed medically without revascularization (P <0.001 for all PAQ sub-domains; Figure 1). Conclusion: Patients with PAD who received early revascularization had worse health status at baseline, but they reported a greater degree of improvement over 1 year of follow-up when compared to patients managed medically without revascularization. Summarizing real-world health status benefits following a PAD diagnosis is critical to help guide preference-sensitive decisions on PAD management.

scholarly journals Early Transformed Diabetic Foot Ulcer into a Malignancy: A Case Report

2018 ◽  
Vol 22 (2) ◽  
pp. 78
Author(s):  
Sung Bum Park ◽  
Young Koo Lee ◽  
Doo Hyung Lee ◽  
Sue Min Kim ◽  
Hie Won Bae ◽  
...  
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer

Low back pain and calf pain in a recreational runner masking peripheral artery disease: A case report

2019 ◽  
pp. 1-12
Author(s):  
Fabrizio Brindisino ◽  
Denis Pennella ◽  
Giuseppe Giovannico ◽  
Giacomo Rossettini ◽  
John D. Heick ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Peripheral Artery Disease ◽  
Low Back ◽  
Peripheral Artery ◽  
Recreational Runner ◽  
Artery Disease ◽  
Calf Pain

scholarly journals Optimizing medical management in peripheral artery disease

2018 ◽  
Vol 105 (9) ◽  
pp. 1079-1081 ◽  
Author(s):  
P. A. Coughlin ◽  
J. H. F. Rudd
Keyword(s):  
Peripheral Artery Disease ◽  
Medical Management ◽  
Peripheral Artery ◽  
Artery Disease
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