[Algorithm for balloon angioplasty in patients with critical limb ischemia with diabetic foot syndrome].

UNLABELLED: Currently, there is no reliable and ideal criterion for assessing the level of tissue viability in critical limb ischemia in patients with diabetic foot syndrome, which does not allow the selection of patients for revascularization.

AIM: The aim is to investigate the microcirculation of the lower extremities before and after balloon angioplasty and to develop an algorithm for its implementation depending on the characteristics of purulent-necrotic complications.

MATERIALS AND

METHODS

The study was performed in 67 patients with neuroischemic form of diabetic foot syndrome. 3 groups of research were created: the first group included 18 patients with dry gangrene of one toe, several toes or distal foot; in group II - 35 patients with wet gangrene with signs of purulent arthropathy of the toes, phlegmon of the foot and with chronic wounds on the feet and legs; Group 3 - 14 patients diagnosed with purulent-necrotic complications, which were observed in both the 1st and 2nd groups, where patients refused to perform balloon angioplasty. Such patients underwent conservative treatment of lower extremity ischemia.

RESULTS

It was shown that all patients have low levels of TcpO2- less than 30 mm Hg. The change in the value of TcpO2 during treatment turned out to be interesting: Group I indicator before revascularization was - 15.0±1.31 mm Hg, after the restoration of blood flow for 5- 7 days - 35.53±2.92 mm Hg. after 6 months - 36.67±2.35 mm Hg; Group II before revascularization - 10.35±0.74 mm Hg, for 5-7 days - 25.06±1.13 mm Hg, after 6 months - 34.43±1.97 III group at admission to the hospital - 12.14±0.86 mm Hg, for 5-7 days - 17.14±0.9 mm Hg, after 6 months - 13.71±2.2 mm Hg.

CONCLUSIONS

After revascularization, there is a reperfusion syndrome, the severity of which depends on the number of revascularized vessels of the lower extremity. Balloon angioplasty is one of the priority methods of surgical treatment of limb ischemia with lesions of the shin-foot segment.