Wound-directed revascularisation in the Diabetic Foot patients

Shapovalov Danylo Y., Hupalo Yurii M., Shaprynskyi Vasyl V., Shamrai-Sas Artem V., Kutsin Anton N., Gurianov Vitalii G. Wound-directed revascularisation in the Diabetic Foot patients. Journal of Education, Health and Sport. 2021;11(10):289-300. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.10.027 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.10.027 https://zenodo.org/record/5654971 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 30.09.2021. Revised: 12.10.2021. Accepted: 29.10.2021. Wound-directed revascularisation in the Diabetic Foot patients Danylo Y. Shapovalov, Yurii M. Hupalo, Vasyl V. Shaprynskyi, Artem V. Shamrai-Sas, Anton N. Kutsin, Vitalii G. Gurianov State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine”, Kyiv, Ukraine D. Shapovalov - MD, Vascular surgeon, Junior Researcher, State Institution of Sciense “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department, Kyiv, Ukraine, Email: pandanila.kiev@gmail.com, Phone number: +38 (067) 99 00 911, ORCID id:0000-0001-7419-9559 Y. Gupalo - MD., Phd, Leading Researcher, Vascular surgeon, State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department, Kyiv, Ukraine, Email: uriy_gupalo@ukr.net, ORCID id:0000-0002-4273-5799 V. Shaprynskyi - MD., Phd, Senior Researcher, Vascular surgeon, State Institution of Scienсe “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department, Kyiv, Ukraine, Email: vasyl.shaprynskyy@gmail.com, ORCID id:0000-0002-1437-7410 A. Shamray-Sas - MD., Phd, Senior Researcher, Vascular surgeon, Junior Researcher, State Institution of Scienсe “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department, Kyiv, Ukraine, Email: sa-sha-art@bigmir.net, ORCID id:0000-0003-4099-3118 A. M. Kucyn - MD,Vascular surgeon, Postgraduate Student, Department of Minimally Invasive Surgery, State Institution of Scienсe “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department, Kyiv, Ukraine, Email: kutsyn.anton@gmail.com, ORCID id:0000-0001-9421-8032 V. G. Gurianov - Phd, Associate Professor, Department of Public Health Service Management, Bogomolets National Medical University, Kyiv, Ukraine, Email:vggurianov1958@gmail.com, ORCID id:0000-0001-8509-6301 Conflict of interest: no conflicts Contact information: no conflicts Abstract Introduction: Peripheral arterial diseases in patients with diabetic foot have significant features in pathogenesis, manifestations and course compared with peripheral arterial disease. These features require different approaches to treatment and the the angiosome theory can help increase the effectiveness of revascularization in patients with diabetic foot. The aim: Analyse the results of revascularisation of lower extremity arteries in the patients with ischemic diabetic foot ulcers according to the angiosome theory. Materials and metods: We analysed 98 revascularisations of arteries of 77 lower limbs in 74 ischemic diabetic foot patients for the period from 2017 to 2021. Angioplasties were performed in 71 cases (72,5%), open operations – in 21 (21,4%), hybrid operations – 6 (6,1%). According to angiosome theory we divided the revascularizations into two groups. І group – direct revascularizations (DR) – 57 cases, ІІ group – indirect revascurizations (IR) – 21 cases. Results: Within 6 months foot lesions healing fixed in І group (DR) - 81.7%, in ІІ group (IR) – 78.6%. Major amputations were the consequences of 17,1% revascularizations: DR group – 12,4%, IR group – 33,3%. Functional capacity of the lower extremity within one year was saved in 79,3% in DR group and in 57,9% in IR group. Repeated revascularizations accounted for 21,4% of cases: in DR group – 20,5%, in IR group – 25%. The results of the statistical analysis revealed the dependence of the risk of amputation on adherence to angiosome theory during revascularization. Conclusions: Angiosome-targeted revascularization in the area of foot lesions increases efficiency of the revascularization and improves immediate and long-term treatment results. Key words: Diabetic foot; foot lesions; angiosome; revascularization; angioplasty