The method of endovascular treatment of diabetic foot (which is also called angioplasty of the artery of the legs in diabetic foot syndrome) has become a real issue. Surgical intervention is performed without anesthesia, without incision through artery puncture, with minimal blood loss. In this case, it is possible to restore the patency of not only the arteries of the legs, but also the so-called inflow pathways: the iliac and femoral arteries.
This method has been actively developed in the world over the past 5-10 years and with this treatment, limb amputation can be avoided. The operation includes special catheters are inserted into the artery through pre-made punctures. Through these tubes, with the help of special balloons, endovascular surgeons restore patency and expand closed vessels (their narrowing or complete closure and leads to tissue necrosis). After that, special metal frames are placed in the restored lumen — stents, which subsequently prevent the vessels from closing. Progress in the development of angioplasty techniques is due to technological advancements: special instruments make it possible to restore closed vessels with high efficiency, and stents, especially with drug-eluting stents, allow to achieve good long-term results. For all these actions, doctors need a little over an hour.
The method has no restrictions on age and concomitant diseases.
The method, unlike bypass surgery, has no restrictions on age and concomitant diseases. The results of endovascular interventions are really encouraging. Almost immediately on the day of the operation, pain begins to decrease and a rather long process of healing of trophic changes begins. And from that moment on, drug treatment of diabetes and other concomitant diseases and, most importantly, proper medical “care” — local treatment of the diabetic foot, becomes of fundamental importance.
The possibility of restoring regional blood flow at different levels of the leg, low-trauma of the operation, quick rehabilitation, promising immediate and long-term results, improvement of the quality and prognosis of patients’ life make endovascular surgery the method of choice for the treatment of ischemic and neuroischemic forms of DFS.
The key to future success in the treatment of DFS lies in an interdisciplinary approach to treatment. When doctors of various specialties: endocrinologist, general surgeon, pediatrician, vascular — endovascular surgeon, dermatologist unite and work together at different stages of treatment of DFS. This approach was used to create a diabetic foot service at the CELT multidisciplinary clinic. The same approach allowed in the Scandinavian countries to reduce the number of “high” amputations by 4 times, and in the USA by more than 8 times.