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[Revascularization of the diabetic foot]
H Probst1, J M Corpataux, M Dusmet
1Service de chirurgie, CHUV, Lausanne.
Abstract:
Diabetes is an important risk factor for atherosclerosis. The diabetic foot is characterised by the association of arteriopathy and neuropathy. The vascular damage associates a non-occlusive microangiopathy and a macroangiopathy. The first principles of treatment are the control of pain, of an eventual infection, and the restoration of pulsatile blood flow in case of ischemia. Angiologic investigation must be undertaken, as well as an arteriography, in order to plan the revascularisation. The treatment options are angioplasty with or without stenting and surgery. Distal reconstructions with anastomosis to the leg or pedal arteries have a satisfactory limb-salvage rates. This aggressive and systematic approach to the diabetic foot is economically sound, allows hope for limb salvage and improves the quality of life.