scholarly journals Características Clínicas E Imagenológicas De Los Pacientes Con Úlcera Por Pie Diabético Con Tratamiento Endovascular De La Enfermedad Periférica Arterial. Marzo 2015 a Junio 2017.

2019 ◽  
Vol 38 (3) ◽  
Author(s):  
Jossuett Barrios ◽  
Bernardino Denis ◽  
Gilberto Chanis
Keyword(s):  
Peripheral Arterial Disease ◽  
Endovascular Treatment ◽  
Foot Ulcer ◽  
Arterial Disease ◽  
Primary Patency ◽  
Diabetic Patients ◽  
Anterior Tibial Artery ◽  
Below The Knee ◽  
Imaging Characteristics ◽  
Peripheral Arterial

<p>[Clinical and radiological Characteristics of patients with diabetic foot ulcer with endovascular treatment of peripheral arterial disease. March 2015 to June 2017.]</p><p><br /><strong>Resumen</strong><br />Introducción: La Diabetes mellitus es un problema global, y junto a sus complicaciones representa la causa líder de muerte por enfermedades no transmisibles. El 50% de los pacientes con Diabetes presentan signos de compromiso vascular que al complicarse ameritan tratamiento con bypass quirúrgico que es el método convencional, pero se ha visto que la técnica endovascular ha ayudado a disminuir la morbilidad y la mortalidad de estos pacientes, reduciendo además, el número de amputaciones mayores en los pacientes con pie diabético y enfermedad arterial periférica Objetivo: Describir características clínicas e imagenológicas de pacientes diabéticos con tratamiento endovascular de la enfermedad periférica arterial. Metodología: Estudio descriptivo retrospectivo mediante revisión de expedientes clínicos y radiológicos. Utilizando un formulario para la recolección de datos y EpiInfo v7.2 para la creación y análisis la base de datos. Resultados: Participaron 50 pacientes, el 52% pertenecían al sexo femenino, la mayoría de los pacientes pertenecían al grupo de los 61-70 años. La hipertensión arterial fue la comorbilidad más frecuente (78%). La enfermedad arterial por debajo de la rodilla fue la más observada, con afectación de la arteria tibial anterior principalmente (84%). La angioplastia con balón se realizó en el 100% de los casos, con falló en el 8% de los casos. Conclusión: La enfermedad arterial periférica afecta en mayor medida a los vasos de la pierna por debajo de la rodilla. El tratamiento endovascular de las lesiones arteriales periféricas constituye un método con una gran tasa de éxito en el procedimiento inicial.<br /><br /><strong>Abstract</strong><br />Objective: Describe the clinical and imaging characteristics of diabetic patients who underwent endovascular treatment for peripheral arterial disease. Method: A retrospective descriptive study was carried out. We reviewed the data in the clinical and radiological file of the patients included in the study; they were collected in a survey sheet previously authorized by the Bioethics Committee of the Institution. The data obtained were tabulated in the EpiInfo v7.2 program and graphed using the Office Excel 2016 program. Results: Fifty patients who met the inclusion criteria were included in the study, 52% of them were women, mainly in the age group between 61-70 years. Arterial hypertension was the most frequent comorbidity in the study population with 78% of the total patients. Arterial disease below the knee was more frequent, with involvement of the anterior tibial artery in 84% of the patients evaluated. Balloon angioplasty was performed in 100% of the cases, while stent placement was necessary in 10% of the procedures performed. The result of the procedure was not successful only in 4/50 patients performed. 84% of the patients presented primary patency at 6 months of evaluation. Conclusion: Peripheral arterial disease mainly the vessels of the leg below the knee. Endovascular treatment of peripheral arterial injuries is a safe method with a high success rate in the initial procedure, as well as a low recurrence of intervention at least 6 months after the procedure.<br /><br /></p>

scholarly journals Simultaneous Hybrid Treatment of Multilevel Peripheral Arterial Disease in Patients with Chronic Limb-Threatening Ischemia

2021 ◽  
Vol 10 (13) ◽  
pp. 2865
Author(s):  
Felice Pecoraro ◽  
David Pakeliani ◽  
Salvatore Bruno ◽  
Ettore Dinoto ◽  
Francesca Ferlito ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Endovascular Treatment ◽  
Hybrid Approach ◽  
Common Femoral Artery ◽  
Arterial Disease ◽  
Major Amputation ◽  
Primary Patency ◽  
Secondary Patency ◽  
Peripheral Arterial

Background: Hybrid treatments (HT) aim to reduce conventional open surgery invasiveness and address multilevel peripheral arterial disease (PAD). Herein, the simultaneous HT treatment in patients with chronic limb-threatening ischemia (CLTI) is reported. Methods: Retrospective analysis, for the period from May 2012 to April 2018, of patients presenting multilevel PAD with CLTI addressed with simultaneous HT. The outcomes of these interventions were measured the following metrics: early technical successes (within 30 days following treatment) and late technical successes (30 days or more following treatment) and included mortality, morbidity symptoms recurrence, and amputation. Survival and patencies were estimated. The median follow-up was 43.77 months. Results: In the 45 included patients, the HT consisted of femoral bifurcation patch angioplasty followed by an endovascular treatment in 38 patients (84.4%) and endovascular treatment followed by a surgical bypass in 7 patients (15.6%). Technical success was 100% without perioperative mortality. Eight (17.8%) patients presented early complications without major amputations. During the follow-up, seven (15.6%) deaths occurred and six patients (13.3%) experienced symptoms recurrence, with five of those patients requiring major amputation. An estimated survival time of 5 years, primary patency, and secondary patency was 84.4%, 79.2%, and 83.3% respectively. Conclusions: Hybrid treatments are effective in addressing patients presenting with multilevel PAD and CLTI. The common femoral artery involvement influences strategy selection. Larger studies with longer-term outcomes are required to validate the hybrid approach, indications, and results.

scholarly journals Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease

2020 ◽  
Vol 9 (11) ◽  
pp. 3515
Author(s):  
Jetty Ipema ◽  
Rutger H. A. Welling ◽  
Olaf J. Bakker ◽  
Reinoud P. H. Bokkers ◽  
Jean-Paul P. M. de Vries ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Endovascular Treatment ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Arterial Disease ◽  
Bleeding Complications ◽  
Major Adverse Cardiovascular Events ◽  
Below The Knee ◽  
Peripheral Arterial ◽  
Male Rate

After infrainguinal endovascular treatment for peripheral arterial disease (PAD), it is uncertain whether single antiplatelet therapy (SAPT) or dual antiplatelet therapy (DAPT) should be preferred. This study investigated major adverse limb events (MALE) and major adverse cardiovascular events (MACE) between patients receiving SAPT and DAPT. Patient data from three centers in the Netherlands were retrospectively collected and analyzed. All patients treated for PAD by endovascular revascularization of the superficial femoral, popliteal, or below-the-knee (BTK) arteries and who were prescribed acetylsalicylic acid or clopidogrel, were included. End points were 1-, 3-, and 12-month MALE and MACE, and bleeding complications. In total, 237 patients (258 limbs treated) were included, with 149 patients receiving SAPT (63%) and 88 DAPT (37%). No significant differences were found after univariate and multivariate analyses between SAPT and DAPT on 1-, 3-, and 12-month MALE and MACE, or bleeding outcomes. Subgroup analyses of patients with BTK treatment showed a significantly lower 12-month MALE rate when treated with DAPT (hazard ratio 0.33; 95% confidence interval 0.12–0.95; p = 0.04). In conclusion, although patient numbers were small, no differences were found between SAPT and DAPT regarding MALE, MACE, or bleeding complications. DAPT should, however, be considered over SAPT for the subgroup of patients with below-the-knee endovascular treatment.

scholarly journals Risk of Diabetic Foot in Diabetic Patients with Peripheral Arterial Disease

2020 ◽  
Vol 18 (1) ◽  
pp. 38-41
Author(s):  
A. Joshi
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Medical Sciences ◽  
Institutional Review ◽  
Peripheral Arterial ◽  
Ethical Clearance

Background The prevalence of peripheral arterial disease is higher in diabetic patients. And 11.6% of the patients with diabetic foot ulcer have associated peripheral arterial disease. Objective The main objective of the study is to assess the risk of diabetic foot in diabetic patients with peripheral arterial disease. Method This was a case control study conducted in Bir Hospital, National Academy of Medical Sciences (NAMS). The sample size was 173 out of which cases (diabetic foot) and unmatched controls (diabetics without diabetic foot) were divided in the ratio of 1:2. The Odds Ratio (OR) of peripheral arterial disease in diabetic foot was calculated. The study was conducted after taking ethical clearance from Institutional Review Board of National Academy of Medical Sciences. Result There were 173 participants enrolled in the study. Four were excluded, 55 participants were cases of diabetic foot (cases) and 114 participants were diabetics without diabetic foot (controls). The odds of diabetic foot in patients with peripheral arterial disease was 4.12, p < 0.001. Conclusion The risk of diabetic foot in diabetic patients with peripheral arterial disease was higher as compared to diabetic patients without peripheral arterial disease.

Peripheral Arterial Disease in Non-Diabetic Patients is Associated with Worse Outcomes after LVAD Implantation

2021 ◽  
Vol 40 (4) ◽  
pp. S171-S172
Author(s):  
V.T. Truong ◽  
S. Shreenivas ◽  
I. Rajapreyar ◽  
M. Shah ◽  
R.J. Alvarez ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Peripheral Arterial

scholarly journals Perbandingan efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Angelica M. J. Wagiu ◽  
Richard M. Sumangkut ◽  
Heber B. Sapan ◽  
Louise A. J. Waworuntu
Keyword(s):  
Peripheral Arterial Disease ◽  
Proteus Mirabilis ◽  
Peracetic Acid ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Citrobacter Diversus ◽  
Peripheral Arterial ◽  
Topical Antimicrobial

Abstract: Diabetic ulcer is a condition of infection, ulceration, and or destruction of inner skin tissue related to neurological disorders and degrees of peripheral arterial disease (PAD) in diabetic patients. Diabetic ulcer is prone to infection due to decreased immune response, therefore, opportunistic microbes can become pathogens. Infection is sttill a serious problem in diabetic ulcer since the high cost and long duration of treatment lead to complicated neclected ulcer. This study aimed to obtain the present profile of microbes in diabetic ulcers and the effectivitveness of peracetic acid dan feracrylum in the treatment of diabetic ulcers. This was a descriptive analytical study. The ulcer degree was determined by using PEDIS criteria. Pus specimen was taken with a sterile technique using a transport media, cultured in the Baxtec machine, and the microbes were identified and further tested for sensitivity to peracetic acid dan feracrylum 1%. The results showed that of the 57 patients there were 36 females with a mean age of 58.77+ 9.077 years. Most of the patients (30 patients) had diabetic ulcers of 4th degree. The result of pus culture showed Gram negative Proteus mirabilis as the most frequent microbe (17.5%). The sensitivity test showed that 100% of 12 types of microbes, 83.3% of Citrobacter diversus, and 60% of Proteus mirabilis samples were sensitive to peracetic acid, meanwhile, all microbes were resistant to feracrylum 1% dan NaCl as controls,. Conclusion: Peracetic acid was more effective than feracrylum 1% as topical antimicrobial for diabetic ulcer.Keywords: diabetic ulcer, microbe, topical antimicrobial agentAbstrak: Ulkus diabetik adalah suatu kondisi adanya infeksi, ulserasi dan atau kerusakan jaringan kulit yang lebih dalam yang berhubungan dengan kelainan neurologik serta berbagai tingkatan peripheral arterial disease (PAD) pada penderita diabetes melitus (DM). Ulkus diabetik lebih mudah terinfeksi karena respons kekebalan tubuh penderita DM biasanya menurun, bahkan kuman oportunistik juga dapat menjadi patogen. Infeksi masih menjadi masalah yang paling serius dialami penderita ulkus diabetik oleh karena biaya pengobatan yang besar dan waktu perawatan yang lama sehingga ulkus sering dibiarkan terinfeksi dengan komplikasi tanpa perawatan adekuat. Penelitian ini bertujuan untuk memperoleh data terkini pola kuman penderita ulkus diabetik dan untuk mengetahui efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik. Jenis penelitian ini ialah deskriptif analitik. Derajat ulkus dinilai dengan kriteria PEDIS. Spesimen pus diambil secara steril dengan media transpor, ditanam dalam mesin Baxtec, kemudian dilakukan identifikasi kuman dan uji sensitivitas terhadap asam perasetik dan feracrylum 1%. Hasil penelitian memperlihatkan dari 57 penderita ulkus diabetik terbanyak ialah perempuan (36 penderita) dengan rerata usia 58,77+9,077 tahun. Sebagian besar ulkus diabetik (30 penderita) termasuk derajat 4. Hasil kultur memperlihatkan Proteus mirabilis (Gram negatif) yang tersering (17,5%). Hasil uji sensitivitas pola kuman memperlihatkan 100% sampel dari 12 jenis kuman, 83,3% dari Citrobacter diversus, dan 60% dari Proteus mirabilis sensitif terhadap asam perasetik, sedangkan terhadap feracrylum 1% dan NaCl sebagai kontrol, seluruh kuman telah resisten. Simpulan: Asam perasetik lebih efektif dibandingkan feracrylum 1% sebagai antimikroba topikal pada ulkus diabetik.Kata kunci: ulkus diabetik, mikroba, antimikroba topikal

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