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      The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

      research-article
      * ,
      Journal of Diabetes Research
      Hindawi

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          Abstract

          Objective

          The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI.

          Methods

          This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups.

          Results

          There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups ( p > 0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences ( p < 0.005).

          Conclusion

          This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

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          Most cited references20

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          Inter-society consensus for the management of peripheral arterial disease.

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            Charcot arthropathy of the foot and ankle: modern concepts and management review.

            Charcot arthropathy (Charcot neuroarthropathy, diabetic neuropathic osteoarthropathy, or neuropathic arthropathy) remains a poorly understood disease, although recent research has improved our level of knowledge regarding its etiology and treatment. The effects of Charcot arthropathy are almost exclusively seen in the foot and ankle, and the diagnosis is commonly missed upon initial presentation. It has been well established that this complication of diabetes mellitus severely reduces the overall quality of life and dramatically increases the morbidity and mortality of patients. However, there are few high-level evidence studies to support management and treatment options at this point in time. The goal of this study is to evaluate the modern concepts of Charcot arthropathy through a review of the available literature and to integrate a perspective of management from the authors' extensive experience.
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              The Epidemiology of Lower Extremity Amputations in Diabetic Individuals

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                Author and article information

                Journal
                J Diabetes Res
                J Diabetes Res
                JDR
                Journal of Diabetes Research
                Hindawi
                2314-6745
                2314-6753
                2017
                29 August 2017
                : 2017
                : 5670984
                Affiliations
                Department of Interventional Radiology, Adnan Menderes University Medicine Faculty, 09100 Aydın, Turkey
                Author notes
                *Mehmet Burak Çildağ: mbcildag@ 123456yahoo.com

                Academic Editor: Andrea Flex

                Author information
                http://orcid.org/0000-0003-2371-3540
                Article
                10.1155/2017/5670984
                5603105
                b2b3c9a4-d531-4f51-8fc9-becd3d584a63
                Copyright © 2017 Mehmet Burak Çildağ and Ömer Faruk Kutsi Köseoğlu.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 May 2017
                : 17 July 2017
                : 1 August 2017
                Categories
                Research Article

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