Peripheral Vascular Disease Diagnostic Related Outcomes in Diabetic Charcot Reconstruction

Treatment Failures in Diabetic Foot Osteomyelitis Associated with Concomitant Charcot Arthropathy: The Role of Underlying Arteriopathy

“…This is noteworthy, as the general opinion among experts is that CN is associated with good peripheral perfusion, possibly related to an inflammatory process ( Cates et al, 2019 ;Rogers and Laird, 2007 ). One group found no significant difference in the incidence of limb loss between patients with CN reconstruction whose diagnosis of PAD was made clinically or by angiography ( Cates et al, 2019 ). Orioli et al reported in an abstract that among 56 patients with Charcot foot, two-thirds of whom had infection, the prevalence of PAD was 66%, and it affected the infrapopliteal arteries more often than in diabetic foot patients without CN (23).…”

“…A previously unreported finding was identified that may be relevant to the management of patients with DCO: PAD was significantly associated with both overall clinical failure and major amputations. This is noteworthy, as the general opinion among experts is that CN is associated with good peripheral perfusion, possibly related to an inflammatory process ( Cates et al, 2019 ;Rogers and Laird, 2007 ). One group found no significant difference in the incidence of limb loss between patients with CN reconstruction whose diagnosis of PAD was made clinically or by angiography ( Cates et al, 2019 ).…”

Timing of Revascularization and Parenteral Antibiotic Treatment Associated with Therapeutic Failures in Ischemic Diabetic Foot Infections

“…In the literature, the need for urgent surgery largely depends on the patient’s ischemic symptoms [ 32 ]. Some research groups suggest that undertaking early vascular interventions could increase the healing chances, especially in diabetic adults [ 8 , 19 , 20 , 30 ]. Others are less strict, advocating that patients benefitting from revascularization should be selected carefully, including considering the comorbidities, chances of success, and the likelihood of recovery from the infection [ 31 , 37 , 38 ].…”

“…Many clinicians consider clinically significant peripheral artery disease (PAD) a particularly concerning risk for therapeutic failure in patients with DFIs [ 19 , 20 ]. The reduced blood supply impairs the wound healing [ 21 ] as well as the delivery of antibiotics to the infected site.…”

Combined (endo-)vascular intervention and microsurgical lower extremity free flap reconstruction—A propensity score matching analysis in 5386 ACS-NSQIP patients

“…[15][16][17][18][19][20][21][22] These interventions include peripheral angioplasty, arteriovenous loops, bypass, or interposition grafting, and aim to re-establish vascular access to increase perfusion prior to a free tissue transfer. 23 Vascular surgeries such as arteriovenous loops, bypass, or interposition grafting are performed as a primary operation or during the free flap as an index procedure, with varying indications but also complications rates. [24][25][26] Recent studies have supported an "endovascular first" intervention approach, reporting high rates of salvage and excellent long-term prognosis when free flap transfer is used in combination with revascularization.…”