Affiliation:
1. Department of Systems Medicine, University of Rome Tor Vegata, Rome, Italy
Abstract
In developed countries, the prevalence of persons with diabetes and peripheral arterial
disease (PAD) is approximately 50%. The presence of PAD is associated with non-healing ulcers,
major amputation, cardiovascular morbidity, and mortality. It is estimated that persons with diabetes,
foot ulceration and PAD have 50% of 5-years mortality rate. Therefore, subjects with ischemic
diabetic foot ulcers (DFUs) should be considered a special group of patients with specific
clinical characteristics, general health status and prognosis. In persons with ischemic DFUs, an early
diagnosis and treatment are mandatory to reduce the risk of worse outcomes such as major amputation.
Revascularization of occluded lower extremity arteries is the main treatment to restore
blood flow in the foot and promote wound healing. Nonetheless, there are several unmet needs in
the management of diabetic subjects with PAD and foot ulceration as medical therapy, diagnostic
criteria and indications for revascularization, revascularization strategy and technical approach as
well as the management of no-option critical limb ischemia patients. It is a common opinion that
there is an evolution of PAD features in diabetic persons, which seems to present a more aggressive
pattern. This may be related to the frequent presence of concomitant comorbidities such as renal
failure which could influence the characteristics of atherosclerotic plaques and their distribution.
The aim of this review is to commence a complete overview and state of the art in the treatment
of patients with diabetes, PAD, and foot ulceration and to describe the current challenges and
future perspectives.
Publisher
Bentham Science Publishers Ltd.
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism
Cited by
12 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献