J Korean Foot Ankle Soc.  2007 Dec;11(2):216-220.

The Usefulness of Infrapopliteal Percutaneous Transluminal Angioplasty in the Treatment of Diabetic Gangrene

Affiliations
  • 1Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. coolhkshin@skku.edu
  • 2Department of Physical Medicine & Rehabilitation, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) below the knee as a treatment in diabetic foot gangrene.
MATERIALS AND METHODS
Between May 2003 and May 2006, angiography was performed in 35 diabetic foot gangrene classified as either Wagner grade IV or V. Infrapopliteal PTA was performed in 10 patients among them. Clinical success was defined as prevention of major amputation.
RESULTS
Among 25 patients who did not receive infrapopliteal PTA, the major amputation rate is 22% (in one arterial occlusion cases), 50% (in two arterial occlusion cases), 63% (in three arterial occlusion cases), respectively. Infrapopliteal PTA was successfully performed in 8 among 10 patients. Two patients were failed and undergone below-knee amputation. Toe amputation were performed in 2 patients with one arterial occlusion. Out of 6 patients with three arterial occlusions, toe amputations were performed in 4 patients and the other 2 patients were healed through debridement.
CONCLUSION
As a first choice revascularization procedure for limb salvage in diabetic foot gangrene, infrapopliteal PTA can be one of treatment options.

Keyword

Diabetic foot gangrene; Infrapopliteal percutaneous transluminal angioplasty; Major amputation

MeSH Terms

Amputation
Angiography
Angioplasty*
Debridement
Diabetic Foot
Gangrene*
Humans
Knee
Limb Salvage
Toes
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