Indicações cirúrgicas para lesões arteriais periféricas em paciente com diabetes

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Indicações cirúrgicas para lesões arteriais periféricas em paciente com diabetes

Mensagem  Ivy Carolina em Seg Out 13, 2014 10:48 pm

Indicações de abordagens cirúrgicas para o tratamento de doença arterial periférica em paciente com mais de 50 anos com pé diabético.

MEDSCAPE. The Role of Peripheral Arterial Disease in the Pathogenesis of Diabetic Foot Disease: When to Refer for Vascular Surgery. Disponível em <http://www.medscape.com/viewarticle/579839> Acesso em: 13 out. 2013.


MEDSCAPE. The Interventional Therapy for Diabetic Peripheral Artery Disease. Disponível em < http://www.medscape.com/viewarticle/811577> Acesso em: 13 out. 2014.

"Two general techniques of revascularization exist: open surgical procedures and endovascular interventions. The two approaches are not mutually exclusive and may be combined(...)"
"Endovascular intervention is more appropriate in patients with focal disease, especially stenosis of larger more proximal vessels, and when the procedure is performed for claudication. Open procedures have been successfully carried out for all lesions and tend to have greater durability. However, open procedures are associated with a small but consistent morbidity and mortality. The choice between the two modalities in an individual patient is a complex decision and requires team consultation.
Major amputation in the neuroischemic foot is necessary and indicated only when there is overwhelming infection that threatens the patient’s life, when rest pain cannot be controlled, or when extensive necrosis secondary to a major arterial occlusion has destroyed the foot. Using these criteria, the number of major limb amputations should be limited.
Most amputations can be prevented and limbs salvaged through a multiarmed treatment of antibiotics, debridement, revascularization, and staged wound closure. On the other hand, amputation may offer an expedient return to a useful quality of life, especially if a prolonged course of treatment is anticipated with little likelihood of healing. Diabetic patients should have full and active rehabilitation following amputation. Decisions should be made on an individual basis with rehabilitative and quality-of-life issues considered highly."

MEDSCAPE. Peripheral Arterial Disease in People With Diabetes. Disponível em <http://www.medscape.com/viewarticle/418239> Acesso em: 13 out. 2014.

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