The angiosome concept in revascularization of the shin and foot arteries in patients with diabetes mellitus

Abstract

Objective. To analyze the results of revascularization of the shin and foot arteries in patients with diabetes mellitus in accordance to the angiosome concept. Materials and methods. Results of roentgen-endovascular interventions on 71 lower extremities, performed in 48 patients, suffering diabetes mellitus and ischemia, menaced for the extremity loss, were analyzed. All the patients had purulent-necrotic affections of the foot Degree III-IV in accordance to classification of WIFI (Wound, Ishemia and Foot Infection). In accordance to anatomic zones of revascularization all roentgen-endovascular interventions were divided into three groups: Group I - 24 (33.8%) direct angiosomic revascularizations, Group II - 38 (53.5%) indirect angiosomic revascularizations, Group III - 9 (12.7%) nonangiosomic revascularizations. Results. There was established, that following the angiosome concept raises possibility of preservation of the lower extremity (92.9%) comparing with nonangiosomic revascularization (77.8%). Conclusion. Efficacy of revascularization of the shin arteries with occlusion-stenotic lesions is significantly higher while restoration of the blood flow in accordance to the angiosome concept.

Keywords

• ischemia; diabetes mellitus; revascularization; roentgen-endovascular interventions; the angiosome concept; purulent-necrotic affections of foot.