Endovascular correction in a patient with diabetic foot syndrome with TASC D leg artery lesion (clinical case)

According to the Russian Ministry of Health, diabetes mellitus currently accounts for 3.3 % of the Russian population. The most dangerous consequences of the global diabetes epidemic are systemic vascular complications, in particular, lesions of the peripheral vessels of the lower extremities. A necessary condition for stopping infectious and trophic processes in case of obstruction of limb vessels is the restoration of the main blood flow. In recent years, preference has been given to endovascular revascularization methods. The aim of the work is to demonstrate a clinical observation and evaluate the effectiveness of endovascular transluminal balloon angioplasty (TLBA) for the correction of TASC D leg lesions in a patient with diabetic foot syndrome (DFS), as well as to analyze the literature data on the use of this technique in lower extremity vascular lesions. Material and methods. The clinical part of the work was carried out on the basis of the surgical departments of the State Healthcare Institution City Clinical Hospital of Emergency Medical Care No. 25 of Volgograd. Traditional research methods were used to diagnose lower extremity vascular lesions: duplex scanning of the lower extremity vessels, selective angiography of the arteries of the left lower extremity. The information bases were the following data: PubMed, CyberLeninka, Google Scholar, Medline, eLIBRARY and the Russian Diabetes Registry of 2021. Results. A review of studies devoted to the study of the possibilities of lower extremity revascularization in the treatment of patients with diabetic foot syndrome shows that TLBA in patients with critical limb ischemia to preserve it costs the state 4–7 times less than amputations and subsequent stages of prosthetics and rehabilitation. Reconstructive surgeries give positive results of limb revascularization in 70–80 %. The article presents a clinical observation demonstrating the possibility and effectiveness of endovascular balloon angioplasty as one of the options for endovascular correction in purulent-necrotic lesions of the foot in a patient with diabetic foot syndrome against the background of TASC D leg artery lesions. Conclusion. Transluminal balloon angioplasty against the background of critical ischemia of the leg arteries in patients with diabetes mellitus can be considered as the operation of choice for limb salvation.