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Prospective, Randomized, and Controlled Study of a Human Umbilical Cord Mesenchymal Stem Cell Injection for Treating Diabetic Foot Ulcers
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Below-the-Knee Intervention for Ischemic Diabetic Foot in Kurdistan, Iraq: A Case-Control Study
Aram Jamal Mirza1, Naser Abdullah Mohammed2, Abdulsalam Yaseen Taha3
1Department of Interventional Cardiology, Slemani Cardiac Hospital, Sulaymaniyah, Iraq.
Annals of Vascular Surgery
|September 14, 2020
Summary
Percutaneous transluminal angioplasty (PTA) improved ulcer healing in patients with ischemic diabetic foot compared to conservative therapy. While amputation and death rates were similar, PTA offered better outcomes for diabetic foot ulcers.
Area of Science:
- Vascular Surgery
- Diabetology
- Interventional Cardiology
Background:
- Diabetic foot (DF) management is complex, especially with infrapopliteal arterial disease.
- Treatment options include observation, bypass surgery, and endovascular intervention.
- This study compares percutaneous transluminal angioplasty (PTA) with conservative therapy for ischemic DF.
Purpose of the Study:
- To evaluate the effectiveness of PTA versus conservative management for ischemic diabetic foot.
- To compare ulcer healing rates, recurrence, and amputation rates between the two treatment groups.
Main Methods:
- A prospective study involving 40 patients undergoing PTA and 78 patients in a conservative control group.
- Patients received clinical assessment, Doppler ultrasonography, and CT angiography.
- Conventional angiography was used for the PTA group, with outcomes compared to the control group.
Main Results:
- The PTA group showed significantly higher ulcer healing rates (67.5% vs. 34.6%) and lower recurrence rates (20% vs. 47.4%).
- Amputation rates were similar between groups (12.5% vs. 12.8%).
- The study involved a mean age of 64 years, with complex arterial lesions in most patients.
Conclusions:
- Endovascular intervention (PTA) demonstrates superior ulcer healing for ischemic diabetic foot compared to conservative approaches.
- While not significantly reducing amputation or death rates, PTA improves key ulcer-related outcomes.
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