Diabetická noha z pohledu cévního chirurga - kazuistika

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Title in English Diabetic foot from the view of a vascular surgeon - case report
Authors

STAFFA Robert PŘÍVARA Mojmír HOLUB Radim

Year of publication 2002
Type Article in Periodical
Magazine / Source Diabetologie, metabolismus, endokrinologie, výživa (DMEV)
MU Faculty or unit

Faculty of Informatics

Citation
Field Surgery incl. transplantology
Keywords reconstruction crural; distal; pedal; diabetic foot; angiography
Description Diabetic foot is still a problem that requires multiprofessional cooperation. The authors present a case of a patient with a progredient moist gangrene of the right foot. In this patient, amputation of the lower limb was indicated because of an unfavourable angiographic finding, after unsuccessful conservative treatment. With regard to the fact, that the patient had undergone amputation of the other lower limb in the crus, revision of the posterior tibial artery was decided. Peroperative angiography did not confirm the previous unfavourable angiographic finding. After the implantation of a distal crural venous bypass (posterior tibial artery supramalleolar part), healing of the extremity occurred in a relatively short time period. The authors agree with the opinion that distal crural and pedal bypasses cannot be always indicated on the basis of routinely performed angiography. Revision of crural arteries and possible peroperative angiography can change the situation and lead to the salvage of the limb. The basic precondition , however , remains a close cooperation of diabetologists, angiologists, and vascular surgeons, so that the possibilities of vascular surgery can be considered in time, when the limb ischemia has not become irreversible.
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