[Revascularization in patients with diabetes].
Kunihiro Shigematsu, Tetsuro Miyata
Abstract
Kunihiro Shigematsu, Tetsuro Miyata
Abstract
Diabetic foot is one of the challenging diseases in vascular surgery, especially in patients with end-staged renal disease due to diabetic nephropathy. This disease is based on the neuropathic gangrene due to microangiopathy as well as on the macroangiopathy such as peripheral arterial occlusive disease. Therefore, the strategy for diabetic foot is as follows: the first step is the infection control by minor amputation and/or drainage, the second step is the assessment of the limb ischemia, and the final is the complete vascular reconstruction such as distal bypass to the crural arteries. To salvage the diabetic foot, it is important that doctors, who concern to diabetics, understand these strategies and also that they have a settled opinion for the diabetic foot.
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Diabetic foot is one of the challenging diseases in vascular surgery, especially in patients with end-staged renal disease due to diabetic nephropathy. This disease is based on the neuropathic gangrene due to microangiopathy as well as on the macroangiopathy such as peripheral arterial occlusive disease. Therefore, the strategy for diabetic foot is as follows: the first step is the infection control by minor amputation and/or drainage, the second step is the assessment of the limb ischemia, and the final is the complete vascular reconstruction such as distal bypass to the crural arteries. To salvage the diabetic foot, it is important that doctors, who concern to diabetics, understand these strategies and also that they have a settled opinion for the diabetic foot.
Key concepts: Medicine, Gangrene, Diabetes mellitus, Diabetic foot, Revascularization, Amputation, Diabetic nephropathy, Microangiopathy