scholarly journals Stimulation TcPO2 Testing Improves Diagnosis of Peripheral Arterial Disease in Patients With Diabetic Foot

2021 ◽  
Vol 12 ◽  
Author(s):  
Vladimíra Fejfarová ◽  
Jiří Matuška ◽  
Edward Jude ◽  
Pavlína Piťhová ◽  
Milan Flekač ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Test Group ◽  
Duplex Ultrasound ◽  
Diagnostic Procedures ◽  
Study Groups ◽  
Arterial Disease ◽  
Stimulation Test ◽  
Clinical Trial Registration ◽  
Peripheral Arterial

BackgroundAll diagnostic procedures of peripheral arterial disease (PAD) in diabetic foot (DF) are complicated due to diabetes mellitus and its late complications.The aim of our study is to enhance diagnosis of PAD using a novel transcutaneous oximetry (TcPO2) stimulation test.MethodsThe study comprised patients with mild-to-moderate PAD(WIfI–I 1 or 2) and baseline TcPO2 values of 30-50 mmHg.TcPO2 was measured across 107 different angiosomes. Stimulation examination involved a modification of the Ratschow test. All patients underwent PAD assessment (systolic blood pressures (SBP), toe pressures (TP), the ankle-brachial indexes (ABI) and toe-brachial indexes (TBI), duplex ultrasound of circulation). Angiosomes were divided into two groups based on ultrasound findings: group M(n=60) with monophasic flow; group T(n=47) with triphasic flow. Large vessel parameters and TcPO2 at rest and after exercise (minimal TcPO2, changes in TcPO2 from baseline (Δ,%), TcPO2 recovery time) measured during the stimulation test were compared between study groups.ResultsDuring the TcPO2 stimulation exercise test, group M exhibited significantly lower minimal TcPO2 (26.2 ± 11.1 vs. 31.4 ± 9.4 mmHg; p<0.01), greater Δ and percentage decreases from resting TcPO2 (p=0.014 and p=0.007, respectively) and longer TcPO2 recovery times (446 ± 134 vs. 370 ± 81ms;p=0.0005) compared to group T. SBPs, TPs and indexes were significantly lower in group M compared to group T. Sensitivity and specificity of TcPO2 stimulation parameters during PAD detection increased significantly to the level of SBP, ABI, TP and TBI.ConclusionCompared to resting TcPO2, TcPO2 measured during stimulation improves detection of latent forms of PAD and restenosis/obliterations of previously treated arteries in diabetic foot patients.Clinical Trial RegistrationClinicalTrials.gov [https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009V7W&selectaction=Edit&uid=U0005381&ts=2&cx=3j24u2], identifier NCT04404699

scholarly journals SKRINING KAKI DIABTES UNTUK DETEKSI DINI LUKA KAKI DIABETES PADA PASIEN DIABETES

2020 ◽  
Vol 6 (2) ◽  
pp. 192-198
Author(s):  
Juhelnita Bubun ◽  
Saldy Yusuf ◽  
Yuliana Syam ◽  
Wahyu Hidayat ◽  
Suharno Usman
Keyword(s):  
Peripheral Arterial Disease ◽  
Scoping Review ◽  
Diabetic Foot ◽  
Full Text ◽  
Arterial Disease ◽  
Key Word ◽  
Diabetic Foot Screening ◽  
Peripheral Arterial

Latar Belakang: Prognosis LKD yang tidak dirawat dengan baik akan berdampak buruk yaitu amputasi bahkan kematian sehingga dibutuhkan tindakan pencegahan yaitu skrining kaki diabetes. Tujuan dari review ini, untuk mengetahui metode skrining kaki diabetes untuk mencegah terjadi luka kaki diabetes (LKD). Metode database yang digunakan pada pencarian artikel yaitu pubmed, wiley dan science direct. Hasil: kata kunci yang digunakan diabetic foot screening OR diabetes foot screening jumlah artikel yang didapatkan   39 artikel dari tiga database dan artikel yang menjadi kriteria inklusi artikel, artikel tahun 2013-2018, merupakan hasil penelitian, sesuai tema  scoping review dan artikel full text, sehingga terdapat empat artikel yang terinklusi. Dari artikel tersebut dua artikel yang membahas metode skrining kaki diabetes untuk mendeteksi neuropati dan dua artikel yang membahas metode skrining kaki diabetes untuk mendeteksi angiopati. Skrining kaki diabetes untuk mendeteksi neuropati dapat menggunakan metode sudoscan yang dapat mendeteksi 34% tidak ada neuropati, tanpa gejala 69% dan dengan gejala 61,7%. Metode Ipswich touch test (IpTT) dapat digunakan oleh tenaga non professional di rumah dan klinik dalam mendeteksi neuropati dengan sensitivitas 78,3% dan 81,2%, spesifitas 93,9% dan 96,4%. Metode dalam mendeteksi angiopati adalah ankle brachialis index (ABI). Kombinasi hasil palpasi nadi yang lemah /hilang dan ABI yang abnormal menghasilkan sensitivitas dan nilai prediksi negatif tertinggi (92,3 % dan 89,8%) penyebab peripheral arterial disease (PAD). Kesimpulan: metode skrining kaki diabetes untuk mendeteksi neuropati terdiri atas beberapa metode yang aman untuk digunakan. ABI dapat digunakan mendeteksi PAD. Key word: skrining kaki diabetes, neuropati, angiopati

scholarly journals Self-reported symptoms on questionnaires and anatomic lesions on duplex ultrasound examinations in patients with peripheral arterial disease

2012 ◽  
Vol 55 (4) ◽  
pp. 1025-1034.e2 ◽  
Author(s):  
Moniek van Zitteren ◽  
Patrick W. Vriens ◽  
Jan M. Heyligers ◽  
Desiree H. Burger ◽  
Maria J. Nooren ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Duplex Ultrasound ◽  
Arterial Disease ◽  
Peripheral Arterial

scholarly journals RR9. Characterization of Tibial Velocities by Duplex Ultrasound in Severe Peripheral Arterial Disease and Healthy Controls

2015 ◽  
Vol 61 (6) ◽  
pp. 191S-192S
Author(s):  
Jeff D. Crawford ◽  
Nicholas G. Robbins ◽  
Lauren A. Harry ◽  
Dale G. Wilson ◽  
Vincent J. Santo ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Duplex Ultrasound ◽  
Arterial Disease ◽  
Healthy Controls ◽  
Peripheral Arterial

Wound management of chronic diabetic foot ulcers: From the basics to regenerative medicine

2015 ◽  
Vol 39 (1) ◽  
pp. 29-39 ◽  
Author(s):  
Karen L Andrews ◽  
Matthew T Houdek ◽  
Lester J Kiemele
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Arterial Disease ◽  
Current Treatment ◽  
Foot Ulcers ◽  
Foot Deformities ◽  
Minor Trauma ◽  
Diabetic Foot Ulcers ◽  
Number Of Patients ◽  
Peripheral Arterial

Background: Hospital-based studies have shown that mortality rates in individuals with diabetic foot ulcers are about twice those observed in individuals with diabetes without foot ulcers. Objective: To assess the etiology and management of chronic diabetic foot ulcers. Study design: Literature review. Methods: Systematic review of the literature discussing management of diabetic foot ulcers. Since there were only a few randomized controlled trials on this topic, articles were selected to attempt to be comprehensive rather than a formal assessment of study quality. Results: Chronic nonhealing foot ulcers occur in approximately 15% of patients with diabetes. Many factors contribute to impaired diabetic wound healing. Risk factors include peripheral neuropathy, peripheral arterial disease, limited joint mobility, foot deformities, abnormal foot pressures, minor trauma, a history of ulceration or amputation, and impaired visual acuity. With the current treatment for nonhealing diabetic foot ulcers, a significant number of patients require amputation. Conclusion: Diabetic foot ulcers are optimally managed by a multidisciplinary integrated team. Offloading and preventative management are important. Dressings play an adjunctive role. There is a critical need to develop novel treatments to improve healing of diabetic foot ulcers. The goal is to have wounds heal and remain healed. Clinical relevance Diabetic neuropathy and peripheral arterial disease are major factors involved in a diabetic foot ulcer. Despite current treatment modalities for nonhealing diabetic foot ulcers, there are a significant number of patients who require amputations. No known therapy will be effective without concomitant management of ischemia, infection, and adequate offloading.

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