[Application of percutaneous transluminal angioplasty in the surgical treatment of patients with diabetic feet].

ABSTRACT

OBJECTIVE: To explore the application of percutaneous transluminal angioplasty (PTA) in the surgical treatment of patients with diabetic feet. METHODS: The clinical data of 83 patients with diabetic feet, 95 limbs (95 wounds) in total, hospitalized in our unit from September 2011 to September 2014, conforming to the study criteria, were retrospectively analyzed. Patients were divided into conventional treatment group (CT, n=43, 51 wounds) and PTA group (n=40, 44 wounds) according to whether receiving PTA treatment or not. Patients in two groups received conventional debridement after admission, and patients in PTA group received another PTA treatment before debridement. Granulation growing well rates of wounds of patients in two groups were calculated on post debridement day (PDD) 3, 6, 9, and 12. Two stage preoperative preparation time of wounds of patients in two groups was recorded. Status of free skin graft survival of wounds and wound healing of patients in two groups were recorded according to the grade of Wagner. Values of ankle-brachial index (ABI) and ulcer recurrence of patients in two groups checked every month during follow-up time of half a year were recorded. Data were processed with chi-square test and t test. RESULTS: Granulation growing well rate of wounds of patients in group CT rose slowly after treatment, which was less than 40% on PDD 12. Granulation growing well rate of wounds of patients in PTA group rose significantly on PDD 9 and all the granulation grew well on PDD 12. On PDD 9 and 12, Granulation growing well rates of wounds of patients in PTA group were significantly higher than those in group CT (with χ(2) values respectively 30.008 and 47.810, P values below 0.01). Two stage preoperative preparation time of wounds of patients in group CT [(24±10) d] was obviously longer than that in PTA group [(15±3) d, t=5.709, P<0.01]. The ratios of survived free skin graft and healed suture in Wagner 2, 3, and 4 wounds of patients in PTA group were significantly higher than those in corresponding Wagner of group CT (with χ(2) values from 6.741 to 24.498, P values below 0.01). During follow-up time of half a year, values of ABI of patients in PTA group every month were significantly higher than those in group CT (with t values from 5.411 to 9.583, P values below 0.01). During follow-up time of half a year, there was no ulcer recurrence in group CT in the first four months, but ulcer recurrence was observed in one patient in the fifth month and in two patients in the sixth month. While no ulcer recurrence was found in PTA group during follow-up time of half a year. CONCLUSIONS: PTA has certain effect and clinical value for the treatment of diabetic foot.