The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

Abstract

Objective The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p > 0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p < 0.005). Conclusion This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

Successful application of extracorporeal circulation compression perfusion in the treatment of diabetic foot: a retrospective cross-sectional study

“…The rising costs to the health care system, especially with repeated vascular surgery, require greater scientific efforts to achieve simpler and more lasting solutions. 12 To date, some pharmacological and biological therapies have demonstrated the ability to improve limb perfusion, but these do have a proven beneficial effect on the clinical end-point of survival after amputation. 12 Therefore, there is still an urgent need for an effective minimally invasive treatment for limb ischemia.…”

“… 12 To date, some pharmacological and biological therapies have demonstrated the ability to improve limb perfusion, but these do have a proven beneficial effect on the clinical end-point of survival after amputation. 12 Therefore, there is still an urgent need for an effective minimally invasive treatment for limb ischemia.…”

“…12 To date, some pharmacological and biological therapies have demonstrated the ability to improve limb perfusion, but these do have a proven beneficial effect on the clinical end-point of survival after amputation. 12 Therefore, there is still an urgent need for an effective minimally invasive treatment for limb ischemia. Khin et al 8 reported temporarily perfusing ischemic limbs with hyperphysiological blood pressure (HELP) using occlusive balloons to isolate ischemic limbs from the systemic circulation.…”