Hybrid Revascularization for Chronic Limb-Threatening Ischemia in Diabetic Patients

Chronic Limb-threatening Ischemia (CLTI) is a massive challenge in terms of revascularization for vascular surgeons. In this article, we studied the hybrid surgical method including open and endovascular surgery in diabetic patients with CLTI. In this prospective study, all the diabetic patients who refer to Golestan Hospital, Center of Vascular Surgery in the South of Iran, because of CLTI were added to this study. Patients were divided into three groups: open surgery, hybrid and angiography. Ischemia and lower limb ulcers were evaluated for all patients. Among ۳۳ participants in the study, ۱۳ were women (۳۹.۴%) and ۲۰ were men (۶۰.۶%). Age range of participants was ۴۷ to ۹۰ years. The rate of gangrene`s outbreak in three different methods of surgery was: open surgery ۷(۷۰%), hybrid ۶(۶۷%), and angiography ۷ (۵۰%) (P=۰.۵۵۸). The rate of bleeding was: mild ۱۳ (۳۹.۴%), moderate ۱۵(۴۵.۴۵%), and severe ۵(۱۵.۱۵%). Patients who underwent hybrid surgery, in compare to other two groups, in terms of infected lower limb had better healing process. Angiography in healing ulcer and ischemia grade has a short-term effect while hybrid surgery and open surgery has long-term effect. In the one-month-follow-up after operation the number of patients who needed minor amputation in those who underwent hybrid surgery was higher. For reaching better results in terms of amputation, more studies are required.

کلیدواژه ها:

Diabetes Mellitus ، Ulcer ، Revascularization ، Hybrid surgery ، Open surgery ، Angiography