J Korean Diabetes.  2019 Mar;20(1):33-41. 10.4093/jkd.2019.20.1.33.

Interventional and Surgical Treatment of Peripheral Artery Disease in Diabetic Patients

• Kim SH

• KMID: 2442351
• DOI: http://doi.org/10.4093/jkd.2019.20.1.33

Abstract

After diagnosis of peripheral artery disease in diabetic patients, revascularization can be considered in those who are not improved after guideline-directed medical therapy. Recently, more aggressive approaches with interventional treatment have been recommended. Before revascularization therapy, it is important to differentiate patients with claudication or critical limb ischemia, and the final goal and treatment modality of interventional treatments should be based on clinical diagnosis. For patients with claudication, the goal of revascularization is improvement of functional capacity or quality of life; however, in more severe forms of critical limb ischemia, the purpose of revascularization is limb salvage and ultimately saving patient's life. With improvement of vascular interventions, interventional treatment for peripheral artery disease is preferred, although surgical treatment might show better results than intervention in some cases.

Keyword

Diabetes mellitus; Intervention; Peripheral arterial disease

MeSH Terms

Diabetes Mellitus
Diagnosis
Extremities
Humans
Ischemia
Limb Salvage
Peripheral Arterial Disease*
Quality of Life

Figure

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  Fig. 1. Management of patients with intermittent claudication (2017 European Society of Cardiology [ESC] guideline). Adapted from the article of 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases (Eur Heart J 2018;39:763-816) [2] with original copyright holder's permission. CFA, common femoral artery; SFA, superficial femoral artery.

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  Fig. 2. Management of critical limb ischemia (2017 European Society of Cardiology [ESC] guideline). Adapted from the article of 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases (Eur Heart J 2018;39:763-816) [2] with original copyright holder's permission. EVT, endovascular therapy; GSV, great saphenous vein.

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