Distální krurální a pedální bypass v léčbě diabetické gangrény

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Title in English Distal, crural and pedal bypass in the treatment of diabetic gangrene
Authors

STAFFA Robert LEYPOLD Jindřich GREGOR Zdeněk PŘÍVARA Mojmír KŘÍŽ Zdeněk

Year of publication 2002
Type Article in Proceedings
Conference Hejhalův den 2002
MU Faculty or unit

Faculty of Informatics

Citation
Field Surgery incl. transplantology
Keywords Distal; crural and pedal bypass; diabetic gangrene
Description The diabetic foot syndrome in its final stage leads to critical ischemia and to gangrene. The attempt at revascularization is often the only possibility how to save the extremity. The authors are submitting case reports of three patients with wet gangrene of the leg, where, on the basis of unfavorable angiography finding and after exhausting possibilities of conservative therapy, amputation of the extremity was considered. Revision of distal sections of crural or pedal arteries and subsequent implementation of bypass reversed the current unfavorable development. In the course of a relatively short time period, defects have been healed and the extremity saved in all three patients. By the description of 3 specified clinical cases (picture documentation of the leg defects before and after operational angiography) the authors open discussions about the possibilities of vascular surgery in solution of the most difficult stages of the diabetic leg syndrome. Angiography often does not inform fully about the situation in uttermost peripheries of limb arteries due to failure to run down of a contrast substance via a number of stenotic and obliterated sections or for the reason of summation with a bone shade. Also during unfavorable angiography finding the authors recommend revision of distal crural or pedal arteries.
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