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Ischemic Charcot foot: different disease with different treatment?

L M Palena1, E Brocco, S Ninkovic

  • 1Interventional Radiology Unit, Policlinico Abano Terme Abano Terme, Padua, Italy. marianopalena@hotmail.com

The Journal of Cardiovascular Surgery
|September 5, 2013
PubMed

Insights

Peripheral arterial disease and Charcot neuroarthropathy in diabetic patients can lead to critical limb ischemia. Revascularization, combined with surgical and orthopedic care, significantly improves limb salvage rates, aiding in foot healing.

Area of Science:

  • Vascular Surgery
  • Diabetology
  • Orthopedics

Background:

  • Diabetic patients with Charcot neuroarthropathy often present with peripheral arterial disease and critical limb ischemia.
  • Foot lesions in these patients require comprehensive management strategies.

Purpose of the Study:

  • To describe the occurrence of peripheral arterial disease in diabetic patients with Charcot neuroarthropathy.
  • To evaluate the effectiveness of revascularization in supporting surgical and orthopedic treatments for limb and foot salvage.

Main Methods:

  • Retrospective analysis of diabetic patients with Charcot neuroarthropathy and critical limb ischemia treated between January 2010 and January 2012.
  • Patients underwent endovascular revascularization followed by surgical debridement and orthopedic correction.
  • Primary endpoint: limb salvage rate; Secondary endpoint: lesion healing time.

Main Results:

  • Ten patients (10 men, mean age 69.1 years) with ischemic Charcot neuroarthropathy were treated.
  • A limb salvage rate of 90% was achieved, avoiding major amputation in 9 patients.
  • Mean healing time for lesions was 197.4 days post-treatment.

Conclusions:

  • Charcot foot deformity can coexist with critical limb ischemia in diabetic patients.
  • Revascularization is crucial for supporting surgical and orthopedic treatments.
  • This combined approach effectively avoids amputation and promotes limb and foot salvage.
Abstract

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