Efficacy of infrapopliteal angioplasty on wound healing in patients with diabetic foot ulcer
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Date
2024-05-18
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SCTIMST
Abstract
Wound healing in patients with diabetic foot ulcer is influenced by the interplay of adequate glycemic control, infection, microangiopathy and vascular compromise. The WIFI (Wound Ischemia Foot Infection) score helps identify patients likely to benefit from endovascular revascularisation. It is therefore important to evaluate and identify the clinico-radiological factors affecting early wound healing. After taking approval from the institutional ethical committee, 107 patients with non-healing diabetic foot ulcer for more than 6 weeks and presenting to interventional radiology or vascular surgery out-patient clinic were prospectively enrolled. Patients with glycosylated hemoglobin levels more than 9 and WIFI score of more than or equal to 3 were excluded from the study. Patients with inline flow in a minimum of at least one infrapoliteal vessel were excluded from the study. Data on demographic, clinical, biochemical, imaging and angiographic data were collected and recorded in excel sheet. Technical success was defined as establishment of inline flow in atleast one of the infrapopliteal vessel. Clinical success was defined as healing of wound within 3 months of revascularisation. Data from the clinical follow-up and doppler assessments till 1 year at 3 monthly interval was recorded. Absence of recent history of smoking, adequate glycemic control and higher number of revascularized target vessels are associated with reduced incidence of major adverse limb events. However, poor glycemic control and wound infection are associated with delayed wound healing despite achieving technical success.