J Korean Orthop Assoc.  2009 Oct;44(5):575-579. 10.4055/jkoa.2009.44.5.575.

Intraoperative Balloon Angioplasty in Diabetic Foot with Peripheral Artery Occlusive Disease During Amputation: Two Case Reports

• Lee YT
• Kim SM
• Yoo JH
• Oh HC
• Ha JW
• Sung SY
• Chang JH
• Yoon HK

• KMID: 2186319
• DOI: http://doi.org/10.4055/jkoa.2009.44.5.575

Abstract

Amputation should be considered for the patients with limb necrosis or infection due to major vessel obstruction combined with diabetes. Patients with peripheral artery occlusive disease combined with diabetes have a higher risk of amputation and a higher possibility of reoperation than those patients without diabetes because of complications that include hematoma, infection and necrosis of the stump. We report here on 2 cases for which balloon angioplasty was used to promote wound healing on the stump site during amputation, and the patients had peripheral artery occlusive disease with a diabetic foot. The wounds healed early without complication in both cases.

Keyword

Diabetic foot; Peripheral artery occlusive disease; Balloon angioplasty

MeSH Terms

Amputation
Angioplasty, Balloon
Arteries
Diabetic Foot
Extremities
Glycosaminoglycans
Hematoma
Humans
Necrosis
Reoperation
Wound Healing
Glycosaminoglycans

Figure

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  Fig. 1 (A) Gross photography showed necrotic change and bulla formation of the right distal lower extremity. (B) Preoperative CT angiography revealed multifocal stenosis of the right anterior tibial (white arrow), posterior tibial (black arrow) and peroneal artery (arrow head).

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  Fig. 2 (A) Gross photography showed a Fogarty Arterial Embolectomy Catheter (Edwards Lifesciences®, CA, USA). (B) The anterior tibial and peroneal artery was identified and intraoperative balloon angioplasty was performed during the amputation. (C) Gross photography of the right stump showed no wound complication 21 days after knee disarticulation.

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  Fig. 3 (A) Gross photography showed necrotic change in the left distal lower extremity. (B) Preoperative CT angiography showed multifocal stenosis of the left anterior tibial(black arrow), posterior tibial(arrow head) and peroneal artery (white arrow). (C) Postoperative 1 month follow up CT angiography showed the increase of blood circulation in the stump.

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