Early outcomes of excimer laser atherectomy for below-the-knee lesions in patients with diabetic foot
10.3760/cma.j.cn112139-20211116-00534
- VernacularTitle:准分子激光消蚀治疗糖尿病足膝下动脉病变效果分析
- Author:
Siyuan ZHOU
1
;
Xiaolang JIANG
;
Shuai JU
;
Xiaoyan LI
;
Bin CHEN
;
Junhao JIANG
;
Daqiao GUO
;
Xin XU
;
Zhihui DONG
;
Weiguo FU
Author Information
1. 复旦大学附属金山医院血管和创面中心 中山糖尿病足多学科诊疗中心及金山运行中心,上海200540
- Keywords:
Diabetic foot;
Lasers,excimer;
Below-the-knee lesion;
Endovascular debulking
- From:
Chinese Journal of Surgery
2022;60(6):599-605
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of excimer laser atherectomy (ELA) in the treatment of diabetic foot with below-the-knee(BTK) lesions.Methods:The clinical data of 11 patients with diabetic foot with BTK lesions who underwent ELA at Department of Vascular Surgery,Zhongshan Hospital of Fudan University and Department of Vascular and Wound Treatment Center,Jinshan Hospital of Fudan University from September 2019 to May 2021 were retrospectively analyzed.There were 10 males and 1 female,aged 70.5 years(range:41 to 83 years).There were 20 lesions in 12 limbs,including 19 chronic total occlusion.All of the limbs were classified as Rutherford class 5 and suffered ulceration.The surgical efficacy,complications and ankle brachial index(ABI) after operation were record.Results:All patients underwent the operation successfully,the technical success rate was 12/12.No distal embolization,flow-limiting dissection,perforation or bailout stenting was occurred.The follow-up period was 8.2 months(range:3 to 13 months).The ABI increased from 0.58(range:0.24 to 1.57) before operation to 0.88(range:0.68 to 1.05) after operation.At 3 months after the operation,1 limb (1/12) underwent endovascular operation again due to restenosis,ulcers were healed in 5 limbs(5/12),and no amputation (limb/toe),death or loss of follow-up patients.Six months after the operation,2 patients were lost to follow-up and 2 died,ulcers were healed in 6 limbs(6/8),1 limb (1/8) underwent toe amputation due to prolonged healing of ulcers of toe.Conclusion:ELA is feasible and effective in the treatment of DF with BTK lesions,providing a new option of debulking atherectomy in such a group of patients.