Treatment of peripheral arterial disease in diabetes: a consensus of the Italian Societies of Diabetes (SID, AMD), Radiology (SIRM) and Vascular Endovascular Surgery (SICVE).
Diabetic foot (DF) is a chronic and highly disabling complication of diabetes. The prevalence of peripheral arterial disease (PAD) is high in diabetic patients and, associated or not with peripheral neuropathy (PN), can be found in 50% of cases of DF. It is worth pointing out that the number of major amputations in diabetic patients is still very high. Many PAD diabetic patients are not revascularised due to lack of technical expertise or, even worse, negative beliefs because of poor experience. This despite the progress obtained in the techniques of distal revascularisation that nowadays allow to reopen distal arteries of the leg and foot. Italy has one of the lowest prevalence rates of major amputations in Europe, and has a long tradition in the field of limb salvage by means of an aggressive approach in debridement, antibiotic therapy and distal revascularisation. Therefore, we believe it is appropriate to produce a consensus document concerning the treatment of PAD and limb salvage in diabetic patients, based on the Italian experience in this field, to share with the scientific community.
P.O. Campobasso - ASReM, Campobasso, Italy.
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Aiello
Servizi di Diabetologia, USL 3, Pistoia, Italy.
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Anichini
Policlinico Abano Terme, Presidio Ospedaliero ULSS 16, Veneto, Italy.
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Brocco
Istituto Clinico "Città Studi", Milan, Italy.
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Caravaggi
A.O. Cannizzaro, Catania, Italy.
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Chiavetta
Dipartimento Radiologia Diagnostica, interventistica e medicina nucleare, Azienda Ospedaliera Universitaria Pisana, Pisa, italy.
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Cioni
Centro Diabetologico Monfalcone (GO) - Ass2, Gorizia, Italy.
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Da Ros
U.O.S. Diabetologia A.O.R.N. "A. Cardarelli", Naples, Italy.
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De Feo
Emodinamica Interventistica Cardiovascolare, Istituto Clinico Città Studi, Milan, Italy.
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Ferraresi
IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
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Florio
Chirurgia Vascolare, Azienda Policlinico S. Orsola-Malpighi, Bologna, Italy.
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Gargiulo
Department of Surgery Vascular and Endovascular Surgery Unit, University of Siena, Siena, Italy.
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Galzerano
Dipartimento Diagnostica per immagini, Imaging molecolare, radioterapia e radiologia interventistica, Policlinico Universitario Tor Vergata, Rome, Italy.
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Gandini
Diabetic Foot Unit, Dept of Internal Medicine, Policlinico Universitario Tor Vergata, Rome, Italy.
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Giurato
Unità Operativa di Cardiologia Invasiva, Istituto Clinico "Città di Brescia", Brescia, Italy.
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Graziani
Istituto Dermatologico Immacolata IRCCS, Rome, Italy.
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Mancini
Radiologia Interventistica, Policlinico Abano Terme, Presidio Ospedaliero ULSS 16, Veneto, Italy.
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Manzi
Dipartimento Malattie Cardiovascolari Fondazione Giovanni Paolo II, Università Cattolica Sacro Cuore, Campobasso, Italy.
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Modugno
Department of Surgery Vascular and Endovascular Surgery Unit, University of Siena, Siena, Italy.
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Setacci
Diabetic Foot Unit, Dept of Internal Medicine, Policlinico Universitario Tor Vergata, Rome, Italy. Electronic address: luigi.uccioli@ptvonline.it.
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Uccioli
D000671:Amputation, Surgical / Q000592:standards; D000800:Angioplasty, Balloon / Q000592:standards; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D057510:Endovascular Procedures / Q000592:standards*; D006801:Humans; D023821:Limb Salvage / Q000592:standards*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000592:standards*
D002317:Cardiovascular Agents
Angioplasty; Diabetic foot; Limb salvage; Peripheral arterial disease