Document Detail


The challenging topic of diabetic foot revascularization: does the angiosome-guided angioplasty may improve outcome.
MedLine Citation:
PMID:  22231524     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The angiosome model was first pioneered by Jan Taylor in 1987 by his influential anatomical works in the plastic reconstructive surgery field. The concept depicts the human body into three-dimensional blocks of tissue, fed by specific arterial and venous irrigation sources, the "angiosomes". Adjacent angiosomes are linked by a vast compensatory collateral web "the choke vessels". This collateral network provides a remarkable "rescue system" in non-atherosclerotic and non-diabetic patients. However, it could be dramatically damaged in chronic limb ischemia (CLI) subjects witnessing miscellaneous systemic arterial disease. The angiosome concept may provide useful information on the human vascular anatomy and related pathology, with specific applications in surgical and vascular interventional therapies. This knowledge may become particularly beneficial in CLI while treating advanced atherosclerotic disease that adds extended collateral depletion. The concept may allow to deliberately focus arterial flow reconstruction in specific limb ischemic areas that exhibit tissue loss and fluctuating "rescue-vessels" supply. The implementation of angiosome-derived strategies in Rutherford grade III CLI presentations, may afford encouraging wound healing and limb preservation rates for both, bypass or endovascular techniques. The present paper proposes a parallel review of the main contemporary publications that share this theory in dedicated CLI literature, with practical considerations for its daily use. Recent applications of the angiosome concept in current CLI revascularization seem to evince benefic results in tissue cicatrization, although comparative and prospective data are further mandatory to cast any pertinent clinical validation.
Authors:
V Alexandrescu; G Hubermont
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  53     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  3-12     Citation Subset:  IM    
Affiliation:
Princess Paola Hospital, Marche-en-Famenne, Belgium - v.alex@skynet.be.
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