The diabetic foot: Pathophysiology, evaluation, and treatment.

Abstract:

:The pathophysiology of the diabetic foot ulcer and soft-tissue infection is due to neuropathy, trauma, and, in many patients, concomitant peripheral artery occlusive disease. Diabetic neuropathy results in foot deformity, leading to increased skin pressure with walking. Once a foot ulcer develops, the limb is at high risk for invasive infection and, when combined with peripheral artery occlusive disease, the patient should be considered to have critical limb ischemia. A multidisciplinary approach to care for the diabetic foot is recommended, which includes annual (3-month intervals in high-risk patients) assessments by a primary care physician and referral to a podiatrist and vascular surgeon for diabetics with a foot ulcer for evaluation of foot arterial perfusion and off-loading therapy to reduce plantar skin pressure with walking. When invasive foot infection develops and tissue beneath the fascia is involved, inpatient care is recommended for systemic antibiotic therapy, vascular laboratory testing of artery limb perfusion, and surgical debridement of infected tissue. The goals of treatment are to achieve a healed foot and keep the patient ambulatory.

journal_name

Semin Vasc Surg

authors

Bandyk DF

doi

10.1053/j.semvascsurg.2019.02.001

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

43-48

issue

2-4

eissn

0895-7967

issn

1558-4518

pii

S0895-7967(19)30011-0

journal_volume

31

pub_type

杂志文章,评审
  • Imaging equipment and techniques for optimal intraoperative imaging during endovascular interventions.

    abstract::Because endovascular procedures represent an ever-increasing portion of many vascular surgery practices, many surgeons are faced with difficult choices. Endovascular procedures often require open surgery, and open surgical techniques increasingly require fluoroscopic imaging. Without good intraoperative imaging, endov...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Fillinger MF,Weaver JB

    更新日期:1999-12-01 00:00:00

  • Evolution of carotid stenting: indications.

    abstract::While carotid angioplasty and stenting has been clearly established as a minimally invasive alternative to endarterectomy for patients with carotid occlusive disease, its indications continue to evolve, being refined as more controlled data of large studies are being accumulated. The purpose of this article is to revi...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2008.03.003

    authors: Chaer RA,Makaroun MS

    更新日期:2008-06-01 00:00:00

  • Management of the tense abdomen or difficult abdominal closure after operation for ruptured abdominal aortic aneurysms.

    abstract::Increased intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) are important clinical problems after repair of ruptured abdominal aortic aneurysms and are reviewed here. IAP >20 mm Hg occurs in approximately 50% of patients treated with open abdominal aortic aneurysm repair after rupture, and approx...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2012.03.002

    authors: Björck M

    更新日期:2012-03-01 00:00:00

  • Aortomonoiliac endovascular grafting combined with femorofemoral bypass: an acceptable compromise or a preferred solution?

    abstract::The relative merits of aortomonoiliac and bifurcated stent-graft configurations depend on the patient's arterial anatomy and clinical status. Aortomonoiliac stent-grafts are simple to make, simple to insert, and versatile. They are most useful when the iliac artery anatomy is severely distorted and the patient is old,...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章

    doi:

    authors: Chuter TA,Faruqi RM,Reilly LM,Kerlan RK,Sawhney R,Wall SD,Canto K,Gordon RL,Messina LM

    更新日期:1999-09-01 00:00:00

  • Endografts for the treatment of aortic infection.

    abstract::Aortic infection is an uncommon but life-threatening condition. Conservative medical treatment is insufficient in many cases because of the high risk of persistent infection, aortic rupture, and death. Conventional open surgical treatment consists of extensive tissue debridement, complete removal of the infected prost...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2011.10.009

    authors: Setacci C,de Donato G,Setacci F

    更新日期:2011-12-01 00:00:00

  • Carotid artery disease in women.

    abstract::Our understanding of cerebrovascular disease in women is hampered by a paucity of studies that include adequate numbers of female patients. Most studies are heavily biased toward men. Although women have fewer strokes than men and have a better long-term prognosis after strokes or TIAs, cerebrovascular disease still a...

    journal_title:Seminars in vascular surgery

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:

    authors: Hurlbert SN,Krupski WC

    更新日期:1995-12-01 00:00:00

  • Endovascular aneurysm sealing addresses several limitations of conventional endovascular aneurysm repair.

    abstract::Endovascular aneurysm repair has enabled a broad population of patients with infrarenal abdominal aortic aneurysm to be treated by a less-invasive technique. However, endovascular aneurysm repair has therapeutic limitations, including the need for lifelong surveillance and a higher rate of secondary interventions than...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2016.06.004

    authors: Kostun ZW,Woo EY

    更新日期:2016-03-01 00:00:00

  • New strategies in platelet inhibition in noncoronary interventions.

    abstract::Thrombembolic complications frequently occur during and after endovascular procedures because of associated arterial injury and thrombotic characteristics of implanted devices such as stents. New strategies in platelet aggregation inhibition are now available blocking the final and common pathway of platelet aggregati...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/svas.2001.23171

    authors: Tepe G,Hahn U,Pusich B,König C,Müller-Schimpfle M,Raygrotzki S,Claussen CD,Duda SH

    更新日期:2001-06-01 00:00:00

  • Aortic reconstruction in infected aortic pathology by femoral vein "neo-aorta".

    abstract::The use of autologous femoral veins for in situ reconstruction of the aortoiliac segment is an effective technique to treat native aorta or prosthetic graft infections. The indications, technical details, and outcomes of this procedure are detailed. Graft infection involving the aortic segment, while rare, remains one...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2019.07.002

    authors: Savlania A,Tripathi RK

    更新日期:2019-01-01 00:00:00

  • Digital fluoroscopy as a valuable adjunct to open vascular operations.

    abstract::The increasing availability of and vascular surgeons' familiarity with digital cine-fluoroscopy in the operating room has been facilitated by the advent and growing popularity of endovascular aortoiliac aneurysm repair and other endovascular techniques that are being incorporated into vascular surgical practice. Digit...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2003.08.006

    authors: Lipsitz EC,Veith FJ,Wain RA

    更新日期:2003-12-01 00:00:00

  • Regional hypothermia with epidural cooling for spinal cord protection during thoracoabdominal aneurysm repair.

    abstract::Several techniques have been developed and clinically applied to reduce the spinal cord ischemia complications that follow thoracoabdominal aortic aneurysm (TAA) repair. Hypothermia as a protective adjunct is a concept that has been used throughout the evolution of cardiac and central aortic surgery. Because experimen...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Cambria RP,Davison JK

    更新日期:2000-12-01 00:00:00

  • The COOK TX2 thoracic stent graft: preliminary experience and trial design.

    abstract::Endovascular treatment of thoracic aortic pathology (ETAP) has been under development for over a decade. Only recently has one device been approved in the United States for treatment of descending thoracic aortic aneurysms. The length of this development process is due to multiple device and deployment system modifica...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2005.11.003

    authors: Hassoun HT,Matsumura JS

    更新日期:2006-03-01 00:00:00

  • Diagnosis and treatment of proximal carotid lesions.

    abstract::Means for endovascular therapy have radically altered the treatment paradigm for occlusive lesions of the aortic arch vessels. Diagnosis of these problems by noninvasive means is becoming increasingly more common, allowing invasive evaluation and treatment to occur simultaneously. Most of these lesions are atheroscler...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Clair DG,Greenberg RK

    更新日期:2000-06-01 00:00:00

  • Aortobifemoral bypass, the gold standard: technical considerations.

    abstract::The controversies that surround the technical aspects of transabdominal reconstruction for aortoiliac occlusive disease, and more specifically ABF, have provided lively debates during the golden era of vascular surgery. It seems almost a pity that, with the resolution of many of these issues, what has become one of th...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Rutherford RB

    更新日期:1994-03-01 00:00:00

  • Microvascular pathophysiology of skeletal muscle ischemia-reperfusion.

    abstract::Ischemia-reperfusion injury is a continuing challenge to vascular surgeons. Microvascular factors and mechanisms underlying edema and compartment syndrome provide a useful end point for analysis and planning of therapy. We review the pivotal role of endothelium-leukocyte interactions and of cytokines in the genesis of...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Durán WN,Takenaka H,Hobson RW 2nd

    更新日期:1998-09-01 00:00:00

  • Renal cell carcinoma accompanied by venous invasion and inferior vena cava thrombus: classification and operative strategies for the vascular surgeon.

    abstract::Venous invasion is a common characteristic of renal cell carcinoma, manifesting as tumor thrombus with possible extension into the renal vein and, in extensive cases, the thrombus can reach from the renal vein to the right atrium. Currently, cytoreductive nephrectomy and tumor thrombectomy are the foundations for impr...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2014.06.015

    authors: Calero A,Armstrong PA

    更新日期:2013-12-01 00:00:00

  • Intraoperative imaging: does it really improve perioperative outcomes of carotid endarterectomy?

    abstract:UNLABELLED:A variety of intraoperative imaging and assessment techniques can be used during carotid endarterectomy (CEA) to evaluate the technical results of the arterial repair. However, the necessity of utilizing these techniques routinely in every case, and the actual ability of these studies to improve the outcomes...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2007.10.003

    authors: Rockman CB,Halm EA

    更新日期:2007-12-01 00:00:00

  • Impact of comorbidities on decision-making in chronic critical limb ischemia.

    abstract::Given both the high-risk nature of the critical limb ischemia (CLI) patient population, as well as the variety of available treatment options, the ability to use preprocedure variables to predict a given outcome has become increasingly important. The three main advantages associated with accurate risk stratification i...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章

    doi:10.1053/j.semvascsurg.2009.10.002

    authors: Schanzer A

    更新日期:2009-12-01 00:00:00

  • Endovascular grafting for aortoiliac occlusive disease.

    abstract::Aortoiliac occlusive disease is a significant cause of lower extremity ischemic symptoms. Over the past two decades, most patients have been treated with a variety of surgical procedures, including aortofemoral and extra-anatomic bypasses. Most recently, percutaneous balloon angioplasty and stents have been successful...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Sanchez LA,Wain RA,Veith FJ,Cynamon J,Lyon RT,Ohki T

    更新日期:1997-12-01 00:00:00

  • Nonocclusive mesenteric hypoperfusion syndromes: recognition and treatment.

    abstract::The main focus when discussing acute or chronic mesenteric ischemia is on occlusive disease, arterial or venous. This article reviews present knowledge on mesenteric nonocclusive hypoperfusion syndromes. The following three clinical entities are reviewed: (1) Intraabdominal hypertension (IAH), or abdominal compartment...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2009.12.009

    authors: Björck M,Wanhainen A

    更新日期:2010-03-01 00:00:00

  • Foam sclerotherapy: an overview of use for primary venous insufficiency.

    abstract::Ultrasound-guided sclerotherapy with foam is able to suppress blood flow in almost all types of varicose veins. The technique is efficient, simple, safe, inexpensive, and easily repeatable, although it requires training and skill. It should be considered as the best primary treatment for most varicose patients. Evalua...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2004.12.008

    authors: Guex JJ

    更新日期:2005-03-01 00:00:00

  • The endovascular repair of abdominal aortic aneurysm: an update analysis of structural failure modes of endovascular stent grafts.

    abstract::Over the last decade, more than 25,000 endovascular stent grafts have been used to treat aortic aneurysms. Although results have been promising thus far, problems with endoleaks, material failure, device migration, and aneurysm rupture continue to be reported. Improvements in device material and design have contribute...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1016/s0895-7967(03)00006-1

    authors: Jacobs T,Teodorescu V,Morrissey N,Carroccio A,Ellozy S,Minor M,Hollier LH,Marin ML

    更新日期:2003-06-01 00:00:00

  • Risk factors for failure of lower-extremity revascularization procedures: are they different for bypass and percutaneous procedures?

    abstract::Restenosis following lower-extremity revascularization remains a significant and costly public health burden. Technical advances in endovascular therapy afford us the choice of treating longer and more distal lesions, which were heretofore reserved for vein bypass surgery. While contemporary vascular surgeons are well...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2008.05.007

    authors: Owens CD,Ho KJ,Conte MS

    更新日期:2008-09-01 00:00:00

  • Predicting which patients will develop chronic critical leg ischemia.

    abstract::Although numerically far less than claudicants, patients with critical leg ischemia (CLI) demand a disproportionately large commitment both in medical effort and economically and represent the major workload for vascular surgical units. The incidence and prevalence of CLI is approximately 500 to 1,000/million/year. Th...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: Dormandy J,Heeck L,Vig S

    更新日期:1999-06-01 00:00:00

  • Popliteal artery aneurysms: tried, true, and new approaches to therapy.

    abstract::Popliteal artery aneurysms are the most common peripheral aneurysm. They are associated with concomitant contralateral popliteal aneurysms and abdominal aortic aneurysms. Patients with unrecognized aneurysms may present with acute limb ischemia and potential for limb loss. Use of preoperative lytic therapy to improve ...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2005.09.009

    authors: Henke PK

    更新日期:2005-12-01 00:00:00

  • Renal nutcracker syndrome: surgical options.

    abstract::Nutcracker syndrome is one of the abdominal venous entrapments, caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Occasionally a retro-aortic left renal vein is compressed between the aorta and the vertebral body (posterior nutcracker syndrome). The renal vein...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2013.04.006

    authors: Said SM,Gloviczki P,Kalra M,Oderich GS,Duncan AA,D Fleming M,Bower TC

    更新日期:2013-03-01 00:00:00

  • Strategies for detection and prevention of spinal cord ischemia during TEVAR.

    abstract::Spinal cord ischemia (SCI) is one of the most feared complications after treatment of thoracic aortic diseases. Based on limited evidence from clinical trials of investigational devices the incidence appears to be lower in endovascular compared to open thoracic aortic repairs. To date, several clinical and procedural ...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2009.07.011

    authors: Feezor RJ,Lee WA

    更新日期:2009-09-01 00:00:00

  • How to interpret data from the superficial femoral artery stenting trials and registries.

    abstract::Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices ...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2010.05.001

    authors: Lin PH,Weakley SM,Kougias P

    更新日期:2010-09-01 00:00:00

  • Management of central vein stenoses and occlusions: the critical importance of the costoclavicular junction.

    abstract::The failure of an autogenous or prosthetic arteriovenous hemodialysis access is usually related to the failure of the venous outflow resulting from a stenosis somewhere in the venous system, commonly at the venous anastomosis for a prosthetic access or within the central veins. The National Kidney Foundation's Kidney ...

    journal_title:Seminars in vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1053/j.semvascsurg.2011.05.008

    authors: Illig KA

    更新日期:2011-06-01 00:00:00

  • History of prosthetic grafts.

    abstract::The evolution of vascular surgery during the past five decades has established what was once controversial to be mandate, what was never dreamed of as debatable, and the vast body of knowledge yet to be unraveled--but requiring clinical application--as currently controversial. Controversy results when dissimilar thera...

    journal_title:Seminars in vascular surgery

    pub_type: 历史文章,杂志文章

    doi:

    authors: Dardik H,Greisler H

    更新日期:1999-03-01 00:00:00