BECS, ISVES 2021, Sofia, Bulgaria – Lecture on endovascular revascularization techniques for patients with diabetic angiopathy.
What was presented at BECS ISVES 2021 in Sofia?
At BECS ISVES 2021 in Sofia, Bulgaria, the talk concerned endovascular revascularisation techniques in patients with diabetic vascular disease.
Revascularisation restores blood flow to the limb and is decisive in the diabetic foot, where timely treatment can prevent amputation.
What is diabetic vascular disease?
Diabetes mellitus damages the vessels at two levels: the large arteries, with accelerated atherosclerosis, and the small vessels. In the lower limbs the occlusions are often located below the knee, where the arteries are fine and access is more difficult.
Which revascularisation techniques are used?
Balloon angioplasty, drug-coated balloons that reduce restenosis, atherectomy for the removal of calcified plaque, and a surgical bypass where needed. The choice depends on the location and extent of the lesion.
Why is it critical in diabetic foot?
In the diabetic foot nerve damage is combined with reduced blood supply. The patient may not feel the wound, while the blood reaching it is not enough to heal it. Without revascularisation, local care is not enough.
What is ISVES?
The International Society of Vascular and Endovascular Surgery organises conferences with an emphasis on practical training and live transmissions of procedures. See also peripheral arterial disease.
How is the diagnosis made?
From palpation of the pulses and the ankle-brachial index, where a value below 0.9 establishes the diagnosis, to colour duplex ultrasound and CT angiography when a procedure is being planned.
Where are the procedures performed?
In the IGS7 hybrid operating room (GE Healthcare) of the Athens Medical Center. See the page on the hybrid operating room and the pioneering procedures.
Diabetic vascular disease often progresses silently, since nerve damage reduces the sensation of pain. The patient may therefore not realise in time that the blood supply has been reduced. Regular vascular assessment in patients with diabetes identifies the problem before an ulcer appears. See the risk factors for vascular disease are.
