Document Detail

Predictive value of angiographic scores for the integrated management of the ischemic diabetic foot.
MedLine Citation:
PMID:  23332244     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To retrospectively evaluate the agreement between the angiographic scores and the clinical outcomes after endoluminal revascularization in diabetic patients with Fontaine stage IV critical limb ischemia (CLI). METHODS: Clinical and procedural data were retrospectively collected of consecutive diabetic patients with Fontaine stage IV CLI who underwent percutaneous lower limb endoluminal revascularization from January 2009 to June 2011. Pre- and postprocedural angiographic images were retrospectively reviewed to classify lower limb arterial involvement according to four systems: (1) TransAtlantic Inter-Society Consensus [TASC] I; (2) TASC II; (3) Graziani's morphologic classification; and (4) Joint Vascular Society Council calf and foot scores. Foot lesions were graded according to the University of Texas wound classification system. Clinical results (healing, nonhealing, or major amputation) were compared with baseline clinical data and angiographic results. RESULTS: In the study period, 202 percutaneous procedures were performed, with an immediate technical success rate of 94%. Preprocedurally, the mean ± standard deviation calf and foot scores were 7.8 ± 1.6 and 7.3 ± 2.3, respectively; 132 patients (65%) were in Graziani's morphologic classes from 4 to 7; in 112 (55%) cases, TASC II was considered inapplicable, for the absence of femoropopliteal lesions; and finally, 93% of limbs were classified as TASC I type D lesions. After the procedure, mean calf and foot scores were 4.8 ± 2.3 and 5.9 ± 2.6, respectively, and 87% of cases were in Graziani's classes 1 and 2; TASC II was inapplicable in all cases, whereas 80% of cases remained TASC I type D lesions. Healing rate was 67% and major amputation rate was 4%. Among all the clinical and angiographic variables included in the analysis, only pre- and postprocedural foot scores were significantly associated to the clinical outcome (P < .05). CONCLUSIONS: Endoluminal revascularization represents a valuable treatment option in diabetic patients with CLI. TASC classifications are inadequate to describe peripheral arterial involvement in the vast majority of diabetic patients with CLI. Pre- and postprocedural foot scores represent the most significant angiographic parameters to evaluate treatment success.
Irene Bargellini; Alberto Piaggesi; Antonio Cicorelli; Loredana Rizzo; Rosa Cervelli; Elisabetta Iacopi; Alessandro Lunardi; Roberto Cioni
Related Documents :
20629074 - Submandibular salivary gland transfer for the prevention of radiation-induced xerostomi...
22974854 - Model for end-stage liver disease dynamic stratification of survival benefit.
10733824 - Bariatric surgery postoperative behavioral change: the importance of ongoing assessment...
17905104 - Predictors of nocturia quality of life before and shortly after prostatectomy.
23640094 - Osseointegrated hearing device placement in congenital lamellar ichthyosis.
23464494 - Long-term follow-up of last autogenous option arm vein bypass.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-16
Journal Detail:
Title:  Journal of vascular surgery     Volume:  -     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy. Electronic address:
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Surgical treatment of Kommerell's diverticulum and other saccular arch aneurysms.
Next Document:  Patient survival after open and endovascular mesenteric revascularization for chronic mesenteric isc...