Fluorescent angiography used as a tool to guide angiosome-directed endovascular therapy for diabetic foot ulcers

Marshall Dworak; Elizabeth A Andraska; S Michael Gharacholou; Melissa Myers; Scott C Chapman

doi:10.1016/j.jvscit.2020.10.014

Fluorescent angiography used as a tool to guide angiosome-directed endovascular therapy for diabetic foot ulcers

J Vasc Surg Cases Innov Tech. 2020 Oct 27;7(1):159-163. doi: 10.1016/j.jvscit.2020.10.014. eCollection 2021 Mar.

Authors

Marshall Dworak^{1

2

3}, Elizabeth A Andraska¹, S Michael Gharacholou², Melissa Myers³, Scott C Chapman¹

Affiliations

¹ Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.
² Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Fla.
³ Department of Critical Care Medicine, Mayo Clinic Health System, La Crosse, Wisc.

Abstract

Angiosome-directed endovascular therapy for the treatment of chronic limb-threatening ischemia (CLTI) remains controversial owing to the overlap of wound angiosomes. Angiographic grading of success has limitations and translesional pressure assessments are seldom performed in the infrapopliteal vessels. Objective criteria to determine revascularization success in tibiopedal vessels have not been well described. Quantifying perfusion to a wound bed after establishing direct or indirect (via collateral) flow after revascularization is an important component for treating CLTI patients yet is seldom performed. We report the use of fluorescent angiography to quantitatively examine perfusion of a diabetic foot ulcer before and after angiosome-directed endovascular therapy.

Keywords: Angiosome-directed endovascular therapy; Fluorescent angiography.

Publication types

Case Reports