Lower limb ischaemia in patients with diabetic foot ulcers and gangrene: Recognition, anatomic patterns and revascularization strategies

Diabetes/Metabolism Research and Reviews

Volumn 32, Issue , 2016, Pages 239-245

  Mills, Joseph L ^a  

^a BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

Angioplasty; Critical limb ischaemia; Diabetic foot ulcer; Limb threatening ischaemia; Lower extremity bypass; PAD in diabetes; Revascularization

Indexed keywords

PACLITAXEL; RAPAMYCIN;

ANATOMICAL CONCEPTS; ANGIOGRAPHY; ANKLE BRACHIAL INDEX; ARTERY DISEASE; ARTICLE; ATHERECTOMY; BARE METAL STENT; CRITICAL LIMB ISCHEMIA; DIABETES MELLITUS; DIABETIC FOOT; DIABETIC PATIENT; DISEASE SEVERITY; DRUG ELUTING STENT; ENDOVASCULAR SURGERY; GANGRENE; HUMAN; LEG ISCHEMIA; LEG REVASCULARIZATION; LIMB AMPUTATION; LIMB SALVAGE; MULTICENTER STUDY (TOPIC); OXYGEN TENSION; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; PERFUSION PRESSURE; PERIPHERAL OCCLUSIVE ARTERY DISEASE; POPLITEAL ARTERY; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); SALVAGE THERAPY; SIROLIMUS ELUTING CORONARY STENT; SKIN CALCIFICATION; SYSTOLIC BLOOD PRESSURE; TIBIOPERONEAL DISEASE; TOE SYSTOLIC PRESSURE; TRANSCUTANEOUS PARTIAL OXYGEN PRESSURE; ULCER HEALING; WOUND INFECTION; ADVERSE EFFECTS; ARTERIOSCLEROSIS OBLITERANS; BLOOD FLOW; BLOOD VESSEL GRAFT; DIABETIC ANGIOPATHIES; EVIDENCE BASED MEDICINE; FOOT; ISCHEMIA; LEG; MULTIMODALITY CANCER THERAPY; ORGANIZATION; PATHOLOGY; PATHOPHYSIOLOGY; PERSONALIZED MEDICINE; RECURRENT DISEASE; SEVERITY OF ILLNESS INDEX; STENT; SURGERY; TRENDS; VASCULARIZATION;

ARTERIOSCLEROSIS OBLITERANS; COMBINED MODALITY THERAPY; CONGRESSES AS TOPIC; DIABETIC ANGIOPATHIES; DIABETIC FOOT; ENDOVASCULAR PROCEDURES; EVIDENCE-BASED MEDICINE; FOOT; GANGRENE; HUMANS; ISCHEMIA; LEG; LIMB SALVAGE; PRECISION MEDICINE; RECURRENCE; REGIONAL BLOOD FLOW; SEVERITY OF ILLNESS INDEX; STENTS; VASCULAR GRAFTING;

EID: 84956765383     PISSN: 15207552     EISSN: 15207560     Source Type: Journal    
DOI: 10.1002/dmrr.2753     Document Type: Article

References (69)

1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF Diabetes Atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabet Res Clin Pract 2011; 94(3): 311-21.
2. Criqui MH. Peripheral arterial disease-epidemiological aspects. Vasc Med 2001 Feb 1; 6(1suppl): 3-7.
3. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 2007; 45(S) Suppl: S5-67.
4. Fontaine R, Kim M, Kieny R. Die chirugische Behandlung der peripheren Durchblutungstörungen. [Surgical treatment of peripheral circulation disorders]. Helv Chir Acta 1954; 21(5-6): 499-533.
5. Rutherford RB, Baker JD, Ernst C, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997; 26: 517-38.
6. Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis. Am Heart Association Circulation 1995 Sep 1; 92(5): 1355-74.
7. O'Hare AM. High prevalence of peripheral arterial disease in persons with renal insufficiency: results from the National Health and Nutrition Examination Survey 1999-2000. Circulation 2004 Jan 19; 109(3): 320-3.
8. McCullough PA, Agrawal V, Danielewicz E, Abela GS. Accelerated atherosclerotic calcification and Monckeberg's sclerosis: a continuum of advanced vascular pathology in chronic kidney disease. Clin J Am Soc Nephrol 2008 Nov; 3(6): 1585-98.
9. American Diabetes Association. Peripheral arterial disease in people with diabetes (Position Statement). Diabet Care 2003; 26: 3333-3341.
10. Ndip A, Jude EB. Emerging evidence for neuroischemic diabetic foot ulcers: model of care and how to adapt practice. Int J Low Ext Wounds 2009; 8: 82-94.
11. Armstrong DG, Cohen K, Courric S, et al. Diabetic foot ulcers and vascular insufficiency: our population has changed, but our methods have not. J Diabetes Sci Technol 2011; 52: 1591-5.
12. Pomposelli FB, Domenig C. Diabetic foot problems. In Comprehensive Vascular and Endovascular Surgery, Hallett JW, Mills JL, Earnshaw JJ, Reekers JA (eds) Eds. Elsevier: New York, 2004; 177-188.
13. Mills JL. Evaluation and management of peripheral arterial disease. In Clinical Care of the Diabetic Foot (2nd edn). American Diabetes Association, Inc: Alexandria, VA, 2010 Chapter 11; 107-116.
14. Strandness DE. Diabetes mellitus and vascular surgery. In Basic Data Underlying Clinical Decision Making in Vascular Surgery, Porter JM, Taylor LM (eds). Quality Medical Publishing: St. Louis, MO, 1994; 30-33.
15. Bell PRF, Charlesworth D, DePalma RG, et al. The definition of critical ischaemia of a limb. Working Party of the International Vascular Symposium. Br J Surg 1982; 69(Suppl): S2.
16. Mills JL, Conte MS, Armstrong DG, et al. The Society for Vascular Surgery lower extremity threatened limb classification system: risk stratification based on wound, ischemia and foot infection (WIfI). J Vasc Surg 2014; 59: 220-34.
17. Cull DL, Manos G, Hartley MC, et al. An early validation of the Society for Vascular Surgery lower extremity threatened limb classification system. J Vasc Surg 2014; 60: 1535-42.
18. Zhan LX, Branco BC, Armstrong DG, Mills JL. The Society for Vascular Surgery (SVS) lower extremity threatened limb classification system based on wound, ischemia, and foot infection (WIfI) correlates with risk of major amputation and time to wound healing. J Vasc Surg 2015; 61(4): 939-944.
19. Causey MW, Ahmed A, Gasper W, et al. SVS limb stage (WIfI) and patient risk (PIII) correlate with midterm outcomes in an amputation prevention program. J Vasc Surg 2015; 61(6): 106-107S.
20. Darling JD, McCallum JC, Soden PA, et al. Predictive ability of the SVS lower extremity guidelines committee wound, ischemia, and foot infection (WIfI) scale for first time revascularizations. J Vasc Surg 2015; 61(6): 24-25S.
21. Akbari CM, Pomposelli FB Jr, Gibbons GW, et al. Lower extremity revascularization in diabetes: late observations. Arch Surg 2000; 135: 452-456.
22. Kalani M, Brismar K, Fagrell B, Ostergren J, Jorneskog G. Transcutaneous oxygen tension and toe blood pressure as predictors for outcome of diabetic foot ulcers. Diab Care 1999; 22: 147-151.
23. DeGraaff JC, Ubbink DT, Legemate DA, Tijssen JGP, Jacobs MJHM. Evaluation of toe pressures and transcutaneous oxygen measurements in management of chronic critical leg ischemia: a diagnostic randomized clinical trial. J Vasc Surg 2003; 38: 528-534.
24. Castronuovo JJ Jr, Adera HM, Smiell JM, Price RM. Skin perfusion pressure measurement is valuable in the diagnosis of critical limb ischemia. J Vasc Surg 1997 Oct; 26(4): 629-37.
25. Tsai FW, Tulsyan N, Jones DN, Abdel-Al N, Castronuovo JJ, Carter SA. Skin perfusion pressure of the foot is a good substitute for toe pressure in the assessment of limb ischemia. J Vasc Surg 2000; 32(1): 32-36.
26. Yamada T, Ohta T, Ishibashi H, et al. Clinical reliability and utility of skin perfusion pressure measurement in ischemic limbs-comparison with other noninvasive diagnostic methods. J Vasc Surg 2008; 47(2): 318-23.
27. Wütschert R, Bounameaux H. Predicting healing of arterial leg ulcers by means of segmental systolic pressure measurements. Vasa 1998 Nov 1; 27(4): 224-8.
28. Braun JD, Trinidad-Hernandez M, Perry D, Armstrong DG, Mills JLS. Early quantitative evaluation of indocyanine green angiography in patients with critical limb ischemia. J Vasc Surg 2013 May; 57(5): 1213-8.
29. Braun JD, Rajguru P, Armstrong DG, Mills JL. Indocyanine green angiographic criteria using ingress and ingress rate to detect SVS lower extremity threatened limb classification (WIfI) grade 3 ischemia. J Vasc Surg 2014 Aug; 60(2): 538.
30. http://www.diabetes.org/diabetes-basics/diabetes-statistics
31. Strandness DE, Priest RE, Gibbons GE. Combined clinical and pathologic study of diabetic and nondiabetic peripheral arterial disease. Diabetes 1964; 13: 366-372.
32. Rogers LC, Andros G, Caporusso J, Harkless LB, Mills JL, Armstrong DG. Toe and flow: essential components and structure of the amputation prevention team. J Vasc Surg 2010; 52(12S): 23-27S.
33. Beach KW, Bedford GR, Bergelin RO, et al. Progression of lower-extremity arterial occlusive disease in type II diabetes mellitus. Diabetes Care 1988; 11: 464-472.
34. LoGerfo FW, Coffman JD. Vascular and microvascular disease of the foot in diabetes. N Engl J Med 1984; 311: 1615-1618.
35. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 1987; 40: 113-41.
36. Iida O, Nanto S, Uematsu M, et al. Importance of the angiosome concept for endovascular therapy in patients with critical limb ischemia. Catheter Cardiovasc Interv 2010; 75: 830-6.
37. Neville RF, Attinger CE, Bulan EJ, Ducic I, Thomassen M, Sidawy AN. Revascularization of a specific angiosome for limb salvage: does the target artery matter? Ann Vasc Surg 2009; 23: 367-73.
38. Söderström M, Albäck A, Biancari F, Lappalainen K, Lepäntalo M, Venermo M. Angiosome-targeted infrapopliteal endovascular revascularization for treatment of diabetic foot ulcers. J Vasc Surg 2013 Feb; 57(2): 427-35.
39. Alexandrescu V, Vincent G, Azdad K, et al. A reliable approach to diabetic neuroischemic foot wounds: below-the-knee angiosome-oriented angioplasty. J Endovasc Ther 2011 Jun; 18(3): 376-87.
40. Sumpio BE, Forsythe RO, Ziegler KR, van Baal JG, Lepantalo MJA, Hinchliffe RJ. Clinical implications of the angiosome model in peripheral vascular disease. J Vasc Surg 2013 Sep; 58(3): 814-26.
41. Rashid H, Slim H, Zayed H, et al. The impact of arterial pedal arch quality and angiosome revascularization on foot tissue loss healing and infrapopliteal bypass outcome. J Vasc Surg 2013 May; 57(5): 1219-26.
42. Azuma N, Uchida H, Kokubo T, Koya A, Akasaka N, Sasajima T. Factors influencing wound healing of critical ischaemic foot after bypass surgery: is the angiosome important in selecting bypass target artery? Eur J Vasc Endovasc Surg 2012; 43: 322-8.
43. Taylor LM Jr, Porter JM. Results of lower extremity bypass in the diabetic patient. Sem Vasc Surg 1992; 5: 226-233.
44. Mills JL, Gahtan V, Fujitani R, Taylor SM, Bandyk DF. The utility and durability of vein bypass grafts originating from the popliteal artery for limb salvage. Am J Surg 1994; 168: 646-651.
45. Pomposelli FB Jr, Kansal N, Hamdan A, et al. A decade of experience with dorsalis pedis artery bypass: analysis of outcome in more than 1000 cases. J Vasc Surg 2003; 37: 307-15.
46. Tannenbaum GA, Pomposelli FB Jr, Marcaccio EJet al.. Safety of vein bypass grafting to the dorsal pedal artery in diabetic patients with foot infections. J Vasc Surg 1992; 15: 982-990.
47. Adam DJ, Beard JD, Cleveland T, Bell J, Bradbury AW, Forbes JF. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet 2005; 366: 1925-34.
48. Pomposelli FB Jr, Jepsen SJ, Gibbons GW, et al. Efficacy of the dorsal pedal bypass for limb salvage in diabetic patients: short term observations. J Vasc Surg 1990; 11: 745-751.
49. Albers M, Romiti M, Brochado-Neto FC, De Luccia N, Pereira CA. Meta-analysis of popliteal-to-distal vein bypass grafts for critical limb ischemia. J Vasc Surg 2006; 43: 498-503.
50. th International Symposium on the Diabetic Foot. Diabetes Metab Res Rev 2008; 24(Suppl 1): S34-9.
51. Faglia E, Dalla Paola L, Clerici G, et al. Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur J Vasc Endovac Surg 2005 Jun; 29(6): 620-7.
52. Dorros G, Jaff MR, Dorros AM, Mathiak LM, He T. Tibioperoneal (outflow lesion) angioplasty can be used as primary treatment in 235 patients with critical limb ischemia five-year follow-up. Circulation 2001; 104(17): 2057-62.
53. Ferraresi R, Centola M, Ferlini M, et al. Long term outcomes after angioplasty of isolated, below-the-knee arteries in diabetic patients with critical limb ischemia. Eur J Vasc Endovasc Surg 2009 Mar; 37(3): 336-42.
54. Cull DL, Langan EM, Gray BH, Johnson B, Taylor SM. Open versus endovascular intervention for critical limb ischemia: a population-based study. J Am Coll Surg 2010; 210(5): 555-61.
55. Jones DW, Schanzer A, Zhao Y, et al. Growing impact of restenosis on the surgical treatment of peripheral arterial disease. J Am Heart Assoc 2013 Nov 25; 2(6): e000345.
56. Bradbury AW, Adam DJ, Bell J, et al. Bypass versus Angioplasty in Severe Ischemia of the Leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg 2010; 51(Suppl): 5S-17S.
57. Feiring AJ, Wesolowski AA. Antegrade popliteal artery approach for the treatment of critical limb ischemia in patients with occluded superficial femoral arteries. Catheter Cardiovasc Interv 2007; 69(5): 665-70.
58. Ozawa N. A new understanding of chronic total occlusion from a novel PCI technique that involves a retrograde approach to the right coronary artery via a septal branch and passing of the guidewire to a guiding catheter on the other side of the lesion. Cathet Cardiovas Interv 2006; 68(6): 907-13.
59. Montero-Baker M, Schmidt A, Bräunlich S, et al. Retrograde approach for complex popliteal and tibioperoneal occlusions. J Endovasc Ther 2008 Oct; 15(5): 594-604.
60. Mustapha JA, Saab F, McGoff T. Tibio-pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: the TAMI technique, original case series. Catheter Cardiovasc Interv 2014; 83(6): 987-94.
61. Spinosa DJ, Harthun NL, Bissonette EA, et al. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subintimal recanalization to treat chronic critical limb ischemia. J Vasc Interv Radiol 2005 Jan; 16(1): 37-44.
62. Bosiers M, Hart JP, Deloose K, Verbist J. Endovascular therapy as the primary approach for limb salvage in patients with critical limb ischemia: experience with 443 infrapopliteal procedures. Vascular 2006; 14(2): 63-9.
63. Feiring AJ, Wesolowski AA. Primary stent-supported angioplasty for treatment of below-knee critical limb ischemia and severe claudication: early and one-year outcomes. J Am Coll Cardiol 2004; 44(12): 2307-14.
64. Rastan A, Tepe G, Krankenberg H, Zahorsky R, et al. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial. Eur Heart J 2011; 32(18): 2274-81.
65. Karnabatidis D, Spiliopoulos S. Primary everolimus-eluting stenting versus balloon angioplasty with bailout bare metal stenting of long infrapopliteal lesions for treatment of critical limb ischemia. J Endovasc Ther 2011; 18(1): 1-12.
66. Todd KE Jr, Ahanchi SS, Maurer CA, Kim JH, Chipman CR, Panneton JM. Atherectomy offers no benefits over balloon angioplasty in tibial interventions for critical limb ischemia. J Vasc Surg 2013 Oct; 58(4): 941-8.
67. Schmidt A, Piorkowski M, Werner M, et al. First experience with drug-eluting balloons in infrapopliteal arteries: restenosis rate and clinical outcome. JAC J Am Coll Cardiol 2011; 58(11): 1105-9.
68. Liistro F, Porto I, Angioli P, et al. Drug-eluting balloon in peripheral intervention for below the knee angioplasty evaluation (DEBATE-BTK): a randomized trial in diabetic patients with critical limb ischemia. Circulation 2013 Aug 6; 128(6): 615-21.
69. Zeller T, Baumgartner I, Scheinert D, et al. Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia: 12-month results from the IN.PACT DEEP randomized trial. J Am Coll Cardiol 2014 Oct 14; 64(15): 1568-76.