Tue, 05/31/2016

PTA in Diabetic Feet to Keep Amputations Low

Around 600 percutaneous transluminal angioplasty (PTA) are carried out each year in different regions of the body trunk by means of interventional radiology solely by the Department of Diagnostic and Interventional Radiology at Hospital Hubertus which is part of the PGD International network of hospitals in Berlin. Around 100 are carried out in the lower leg.

The aim of the surgeries are to re-channel as many primary arteries of the lower leg down to the arch of the pes cavus as possible to achieve a significant improvement in tcpO2 value of the feet. Consequently, the infection and amputation levels of the foot are kept to a minimum.

With diabetes lower leg arteries are usually stenotic or occluded for long segments. Those are usually opened again with antegrade re-channelling techniques by applying thin hybrid wires and up to 20 centimetres long balloons. Increasingly retrograde puncture techniques entering from the foot are applied as randevouz, loop or snare techniques. A special expertise exists in the diabetic foot centre of the hospital for Single-Hole-Kissing techniques on the lower leg.

The technical success of the certification are reviewed externally by the German Society of Interventional Radiology (DeGIR). Particularly important is the review of all clinical successes combined. The success rate of the clinic at PTA, also in the lower leg, is about 98 percent. Complications associated with puncture in terms of re-bleeding or the like is about 4.2 percent. The rate of the dreaded aneurysm spurium (false aneurysm) is only 2.4 percent.

The goal of interventional radiology in our vascular and diabetic foot centre is to safe the limb with minimally invasive surgery by applying high intervention safety at the same time.

Department of Diagnostic and Interventional Radiology, Chief Physician Dr. med. Dirk Meyer-Roelfs