title: Percutaneous transluminal angioplasty for critical limb ischemia in very elderly diabetic patients.
abstract: In diabetic subjects, new less invasive therapies for critical limb ischemia (CLI) are available to obtain limb salvage. One of these is the percutaneous transluminal angioplasty (PTA), a minor surgical intervention which allows obtaining an effective revascularization, avoiding the traditional major surgery and its post-operative complications. Our case report regards a 94-year-old woman with CLI due to critical obstruction (stage IV according to Leriche's classification) of superficial femoral and popliteal arteries and infrapopliteal arteries that should have been treated by the left limb amputation considering her age, severe co-morbidities, and poor compliance. Instead of this quite common approach, our team treated the patient with PTA. This led to very good outcomes, above all in terms of pain control. PTA is able to avoid major surgery, lower intra and post-operative risks, reduce length of hospital stay, and preserve functional autonomy. Therefore, this procedure should be taken into account also for frail very elderly diabetic patients with peripheral artery disease (PAD).
authors.affiliation: Internal medicine, diabetes, endocrine-metabolic diseases and cardiovascular prevention Unit and the Centre for Applied Clinical Research (Ce.R.C.A.), Clinical Institute Beato Matteo, Corso Pavia 84, 27029, Vigevano, Italy. c.gazzaruso@gmail.com
authors.forename: Carmine
authors.initials: C
authors.lastname: Gazzaruso
authors.forename: Adriana
authors.initials: A
authors.lastname: Coppola
authors.forename: Silvia
authors.initials: S
authors.lastname: Collaviti
authors.forename: Cesare Massa
authors.initials: CM
authors.lastname: Saluzzo
authors.forename: Federica
authors.initials: F
authors.lastname: Furlani
authors.forename: Pietro
authors.initials: P
authors.lastname: Gallotti
authors.forename: Jacques
authors.initials: J
authors.lastname: Clerissi
authors.forename: Bruno Sebastiano
authors.initials: BS
authors.lastname: Solerte
authors.forename: Andrea
authors.initials: A
authors.lastname: Giustina
mesh_terms: D000369:Aged, 80 and over; D017130:Angioplasty; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017719:Diabetic Foot / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D023821:Limb Salvage; D058729:Peripheral Arterial Disease / Q000209:etiology / Q000628:therapy*