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KMID : 1190620110070020059
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Journal of the Korean Wound Care Society
2011 Volume.7 No. 2 p.59 ~ p.64
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Revascularization of the Foot
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Joh Jin-Hyun
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Abstract
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Diabetes is the most common underlying cause of foot ulcers, infections, ischemia, and amputations. Overall, patients with diabetes are 15 to 30 times more likely to have an amputation than are patients without diabetes. There are broad spectrum of clinical symptoms and signs with peripheral arterial occlusive disease (PAOD) from asymptomatic to tissue loss. The classical symptom of PAOD is intermittent claudication, which is muscle discomfort in the lower limb reproducibly produced by exercise and relieved by rest within 10 minutes. The term critical limb ischemia (CLI) should be used for all patients with chronic ischemic rest pain, ulcers or gangrene due to PAOD. Revascularization need to the patients with severe claudication and CLI. Diagnostic evaluation of patients with PAOD includes hemodynamic tests and anatomic tests. Hemodynamic tests include ankle pressure measurement, ankle-brachial index, segment limb pressure, treadmill test, Doppler waveform analysis, pulse volume recording and ultrasonography. Anatomic tests include contrast angiography, CT- or MR-angiography. Revascularization can be done with open surgery, endovascular surgery or hybrid surgery. The types of revascularization should be considered after thorough evaluation of patients factor, anatomic factor and facility factors of each hospital.
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KEYWORD
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Diabetes, Peripheral arterial occlusive disease, Critical limb ischemia, Revascularization
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