Percutaneous transluminal angioplasty in the surgical treatment of patients with diabetic feet
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Tyrimo grupės vadovas / Research group head |
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2020-05-15 |
Pataisyta ir papildyta L. Sereikaitės prašymu ir atsiųstu laišku, kuriame patvirtinta, kad praleista autorė Monika Jasinskaitė, ir klaidinga vadovės pavardė.
Case study : Surgery.
ISBN: 978-83-947627-3-5.
Introduction Percutaneous transluminal angioplasty (PTA) can be used to ameliorate tissue perfusion in ischemic diabetic feet. Nevertheless, there are concerns about its feasibility and efficiency in the severely ischemic diabetic foot. This case describes a successful diabetic limb preservation after PTA. Case report A 59 years old female patient who was diagnosed with type-II diabetes at age 36 two years ago worked in a garden and was injured. She was diagnosed with bullous erysipelas, ischemic diabetic foot. Her treatment included antibiotic therapy and left leg a.femoralis and a.poplitea sinistra PTA and a.tibialis anterior recanalization and PTA. Aspirin and clopidogrel were used for the prevention of restenosis. Dynamically, the condition was improving, with antibacterial therapy discontinued, however, in 2019.04, she was hospitalized in the Endocrinology department for the left foot finger gangrene with a spread to the pad. On 2020.02 she underwent finger resection and necrotic mass removal. She was given antibiotic therapy unasyn 1.5 g x 4 i/v and sol. vancomycin 1 g x 2 i/v. During the multidisciplinary consilium, it was decided to remove part of I metatarsal bone in the left foot. 2020.03.15 reconstruction and necrectomy of the proximal end of I metatarsal bone in the left foot was performed. Currently, the left foot has an exuding ulcer. Disscusion/conclusions Patients with diabetic foot remains a clinical and surgical challenge for surgeons. Primarily, peripheral revascularization aims to provide sufficient blood flow to relieve rest pain and facilitate skin wound healing. The results of PTA in diabetic patients have improved, with an acceptable limb salvage rate and perioperative mortality. However, even after successful revascularization local wound treatment must be continued and minor amputation might be performed if appropriate to defend limb salvage. As such, PTA can be an effective method for increasing.