Preoperative visualization of peripheral arteries with duplex ultrasonography in patients with diabetes mellitus and critical limb ischemia

Бондаренко, О. Н.; Ayubova, Natalya L.; Galstyan, Gagik Radikovich; Дедов, И И

doi:10.14341/2072-0351-3756

Cited by 5 publications

(1 citation statement)

References 26 publications

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“…Кальциноз дистальных отделов сосудистого русла является важным звеном патогенеза СДС и самостоятельным фактором риска высоких ампутаций [21]. Протяженные кальцинированные поражения артерий снижают точность ультразвуковой диагностики окклюзирующих изменений, а также приводят к ложно завышенным результатам измерения ЛПИ [25]. Качественная характеристика артериальной стенки возможна при выполнении УЗДС, однако данный метод не позволяет количественно оценить степень кальцинирования.…”

Section: Discussionunclassified

Clinical outcomes of lower limb peripheral vascular disease after endovascular intervention in patients with diabetes mellitus, critical limb ischemia and chronic kidney disease

Ayubova¹,

Бондаренко²,

Galstyan³

et al. 2013

Diabetes mellitus

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Aim. To assess the extent of the lower limb arterial calcification and to evaluate the long-term outcomes of percutaneous transluminal balloon angioplasty (PTBA) in patients with diabetes mellitus (DM), critical limb ischemia (CLI) and chronic kidney disease (CKD). Materials and Methods. 94 patients with CLI formed two groups (CKD-positive and CDK-negative). Quantitative assessment of tibial arterial calcification was performed with non-contrast CT. Outcomes of angioplasty were monitored during the 18?6 months of the follow-up period by means of duplex ultrasonography. Results. Long-term outcomes of PTBA were significantly worse in patients with CKD. Nevertheless, limb preservation and survival rates were relatively satisfactory in both groups (74% and 72%, respectively). Conclusion. PTBA in patients with DM, CLI and CKD presents a technical challenge. Despite that, in many cases the endovascular intervention allows avoiding high-level amputations and improves survival rates.

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Section: Discussionunclassified

Clinical outcomes of lower limb peripheral vascular disease after endovascular intervention in patients with diabetes mellitus, critical limb ischemia and chronic kidney disease

Ayubova¹,

Бондаренко²,

Galstyan³

et al. 2013

Diabetes mellitus

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Features of diagnostics and treatments of the patient with type 2 diabetes mellitus and chronic ischtmia with threating lower limb loss

Bondarenko,

Yaroslavceva,

Galstyan

et al. 2024

Diabetes mellitus

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The article presents the result of our own observation of the patient with a poor control of type 2 diabetes mellitus (DM) for a long period, complicated by obliterating atherosclerosis of the arteries of the lower extremities, Menckeberg’s sclerosis and chronic ischemia threatening loss of the lower extremity (CLLI). A feature of the clinical manifestation are complications associated with potentially regional (angiosomal) ischemia of the foot, as well as variant anatomy, represented by hypoplasia of the vascular lower leg in the patient. The clinical consequences of vascular calcification due to long-term decompensation of carbohydrate metabolism and the development of diabetic distal polyneuropathy (DDP) led to falsely high values of the cuff test in the patient. Disadvantages of non-invasive methods for diagnosing limb ischemia and advantages of the complex application of tests for diseases of the arteries of the lower extremities are discussed. Using WIFI classification according to the degree of ulceration, the degree of ischemia, and the degree of infection on the foot (Wound, Ischemia and Foot Infection), the tactics of managing the patient are presented. The important role of ultrasonic duplex scanning (USDS) in the visualization of the arteries of the legs and feet in patients with DM is substantiated. The importance of a multidisciplinary approach in the management of a comorbid patient with type 2 diabetes and CLTI is emphasized.

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The application of cell products for the treatment of critical limb ischemia in patients with diabetes mellitus: a review of the literature

Chugan,

Lyundup,

Bondarenko

et al. 2024

Probl Endokrinol (Mosk)

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The number of patients with diabetes mellitus (DM) has been progressively increasing worldwide over the past decades, and many international organizations consider DM as a public health emergency of the 21st century.Critical limb ischemia (CLI) is the most severe stage of peripheral arterial disease (PAD) in DM and is characterized by a high risk of limb loss without revascularization. Traditional treatment tactics include open and endovascular revascularization surgical techniques. However, in patients not eligible for revascularization and in cases where performed surgical treatment performed has been ineffective, there are almost no therapeutic alternatives, often leading to amputations and death. As of today, one of the newest non-surgical treatment options is cell therapy. Among different cells, mesenchymal stromal cells (MSCs) are potentially one of the most prospective for use in this patient population.This article provides an overview of clinical trials using cell therapy in patients with CLI.To analyze publications, electronic databases PubMed, SCOPUS, ClinicalTrials, and ScienceDirect were searched to identify published data from clinical trials, research studies, and review articles on cell therapy for critical lower extremity ischemia. After the search, 489 results were received.As a result of systematic selection, 22 clinical trials were analyzed.According to the analyzed literature data, the use of cell products in this category of patients is effective and safe. Cell therapy can stimulate the formation of new vessels and enhances collateral circulation; it is also reported improved distal perfusion, increased pain-free walking distance, decreased amputation rates, and increased survival rates.Nevertheless, further study of the potential use of this category of drugs is needed.

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Preoperative visualization of peripheral arteries with duplex ultrasonography in patients with diabetes mellitus and critical limb ischemia

Cited by 5 publications

References 26 publications

Clinical outcomes of lower limb peripheral vascular disease after endovascular intervention in patients with diabetes mellitus, critical limb ischemia and chronic kidney disease

Clinical outcomes of lower limb peripheral vascular disease after endovascular intervention in patients with diabetes mellitus, critical limb ischemia and chronic kidney disease

Features of diagnostics and treatments of the patient with type 2 diabetes mellitus and chronic ischtmia with threating lower limb loss

The application of cell products for the treatment of critical limb ischemia in patients with diabetes mellitus: a review of the literature

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