Percutaneous transluminal angioplasty in the treatment of diabetic foot ulcer

doi:10.3877/cma.j.issn.2095-5782.2022.03.005

Abstract

Abstract:

Objective

To investigate the efficacy of percutaneous transluminal angioplasty (PTA) in the treatment of diabetic foot ulcer (DFU).

Methods

The clinical data of 39 patients with DFU underwent PTA in our hospital between January 2016 and January 2020 were retrospectively analyzed.All patients were received recombinant bovine basic fibroblast growth factor (rb-bFGF). The success rate of PTA, visual analogue scale (VAS) score and ankle-brachial index (ABI) changes at 1 week after operation, adverse reactions, and ulcer wound shrinkage rate at 15 and 30 days after operation were analyzed.

Results

A total of 39 patients (23 males and 16 females, with an average age of 76.5 ± 5.8 years) were included in this study. Among the 39 patients, 35 patients were treated with PTA alone, and 4 patients were treated with PTA plus stent placement. The success rate of PTA was 92.3% (36/39), 36 patients showed positive blood vessel staining on the angiographosome, and 3 patients failed PTA with the negative blood vessel staining on the angiographosome. Subcutaneous hematomas were occurred in 3 patients and needn't treatment. The pain score of the affected limb was decreased from 8.8 ± 0.7 to 5.3 ± 0.5 (P < 0.05) one week after PTA. The ankle brachial index of the affected limb was increased from 0.37 ± 0.08 to 0.42 ± 0.09 (P < 0.05) one week after PTA. The contraction rates of the ulcer at 15 and 30 days after PTA were 35.5% and 84.7% of patients with PTA successful and were 5.1% and 6.4% of patients who failed PTA (all P < 0.01), respectively.

Conclusions

PTA is an effective method in the management of DFU.

Key words: Diabetic foot, Ulcer, Percutaneous transluminal angioplasty

Jing Zhang, Shaoqin Li, Xiaocheng Gu, Yunfang Han, Xinhua Ye, Haiyang Yu, Jian Wang, Zhongzhi Jia. Percutaneous transluminal angioplasty in the treatment of diabetic foot ulcer[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2022, 10(03): 245-249.

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References 19

[1]	中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(Ⅰ)[J]. 中华糖尿病杂志, 2019, 11(2): 92-108.
[2]	中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(Ⅱ)[J]. 中华糖尿病杂志, 2019, 11(3): 161-189.
[3]	Ornitz DM, Itoh N. The fibroblast growth factor signaling pathway[J]. Wiley Interdiscip Rev Dev Biol, 2015, 4(3): 215-266.
[4]	Yang LJ, Zhang DG, Wu HJ, et al. Basic fibroblast growth factor influences epidermal homeostasis of living skin equivalents through affecting fibroblast phenotypes and functions[J]. Skin Pharmacol Physiol, 2018, 31(5): 229-237.
[5]	Lavery LA, Armstrong DG, Harkless LB. Classification of diabetic foot wounds[J]. Ostomy Wound Manage, 1997, 43(2): 44-48, 50, 52-53.
[6]	中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)（Ⅲ）[J]. 中华糖尿病杂志, 2019, 11(4): 238-247.
[7]	杨川. 《国际糖尿病足工作组糖尿病足慢性创面处理指南》中文译文[J]. 糖尿病天地(临床), 2015, 9(10): 502-506.
[8]	Li L, Chen J, Wang J, et al. Prevalence and risk factors of diabetic peripheral neuropathy in type 2 diabetes mellitus patients with overweight/obese in Guangdong province, China[J]. Prim Care Diabetes, 2015, 9(3): 191-195.
[9]	周秋红, 许景灿, 许樟荣. 国际糖尿病足工作组:糖尿病足防治实践指南《国际糖尿病足工作组：糖尿病足防治国际指南(2019)》的一部分[J]. 感染、炎症、修复, 2019, 20(3): 131-139.
[10]	Fu HD, Wang S, Ge B, et al. Nerve growth factor and substance P may be involved in moist exposed burn ointment-mediated chronic refractory wound healing[J]. Exp Ther Med, 2018, 16(3): 1987-1993.
[11]	Ma Y, Zhao S, Wang X, et al. A new recombinant PACAP-derived peptide efficiently promotes corneal wound repairing and lacrimal secretion[J]. Invest Ophthalmol Vis Sci, 2015, 56(8): 4336-4349.
[12]	许樟荣, 冉兴无. 国际糖尿病足工作组:糖尿病足溃疡周围动脉病变诊断、预后与管理指南《国际糖尿病足工作组:糖尿病足防治国际指南(2019)》的一部分[J]. 感染、炎症、修复, 2019, 20(4): 195-206.
[13]	杨永久, 刘建东. 经皮腔内血管成形术治疗糖尿病足坏疽的临床研究[J]. 中华介入放射学电子杂志, 2015, 3(2): 80-81.
[14]	Faglia E, Mantero M, Caminiti M, et al. Extensive use of peripheral angioplasty, particularly infrapopliteal, in the treatment of ischaemic diabetic foot ulcers: clinical results of a multicentric study of 221 consecutive diabetic subjects[J]. J Intern Med, 2002, 252: 225-232.
[15]	高娅, 崔正军, 史迅, 等. 经皮腔内血管成形术在糖尿病足患者外科治疗中的应用[J]. 中华烧伤杂志, 2016, 32(8): 479-483.
[16]	Chae KJ, Shin JY. Is angiosome-targeted angioplasty effective for limb salvage and wound healing in diabetic foot?: a meta-analysis[J]. PLoS One, 2016, 11: e0159523.
[17]	Iacopi E, Coppelli A, Goretti C, et al. Effect of direct endovascular revascularization based on the angiosome model on risk of major amputations and life expectancy in type 2 diabetic patients with critical limb ischemia and foot ulceration[J]. J Am Podiatr Med Assoc, 2021, 111(4): 3.
[18]	Fu X, Shen Z, Chen Y, et al. Recombinant bovine basic fibroblast growth factor accelerates wound healing in patients with burns, donor sites and chronic dermal ulcers[J]. Chin Med J (Engl). 2000, 113(4): 367-371.
[19]	郑宏庭, 方芳, 陈卫, 等. 重组牛碱性成纤维细胞生长因子治疗糖尿病足：随机对照疗效观察[J]. 中国临床康复, 2004, 8(30): 6564-6565.

参数		例数或均数±标准差
年龄（岁）		76.5 ± 5.8
性别
	男性	23（59.0%）
	女性	16（41.0%）
伴发疾病
	高血压	33（84.6%）
	高脂血症	31（79.5%）
	吸烟史	17（43.6%）
	疼痛程度VAS评分	8.8 ± 0.7
	患肢ABI	0.37 ± 0.08
TEXAS分级
	2级	20（51.3%）
	3级	12（30.7%）
	4级	7（18.0%）
TEXAS分期
	C期	28（71.8%）
	D期	11（28.2%）

参数		例数或均数±标准差
年龄（岁）		76.5 ± 5.8
性别
	男性	23（59.0%）
	女性	16（41.0%）
伴发疾病
	高血压	33（84.6%）
	高脂血症	31（79.5%）
	吸烟史	17（43.6%）
	疼痛程度VAS评分	8.8 ± 0.7
	患肢ABI	0.37 ± 0.08
TEXAS分级
	2级	20（51.3%）
	3级	12（30.7%）
	4级	7（18.0%）
TEXAS分期
	C期	28（71.8%）
	D期	11（28.2%）

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