Angiographic assessment of atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy

• Published in: Journal of the Chinese Medical Association Vol. 81; no. 6; pp. 565 - 570
• Main Authors: Çildağ, Mehmet B., Ertuğrul, Bülent M., Köseoğlu, Ömer FK, Çildağ, Songül, Armstrong, David G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Taiwan LLC 01.06.2018
• Subjects: Aged; Aged, 80 and over; Angiography; Arthropathy, Neurogenic - diagnostic imaging; Atherosclerosis; Atherosclerosis - diagnostic imaging; Charcot neuro-arthropathy; Diabetic foot; Diabetic Foot - diagnostic imaging; Female; Humans; Lower Extremity - diagnostic imaging; Male; Middle Aged; Retrospective Studies; Charcot neuro-arthropathy; Angiography; Atherosclerosis; Diabetic foot
• ISSN: 1726-4901; 1728-7731
• DOI: 10.1016/j.jcma.2017.09.006

The aim of this study was to investigate atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy and compare them with patients with diabetic foot without charcot neuro-arthropathy. This retrospective study consists of 78 patients with diabetic foot who had lower extremity angiography with antegrade approach. All patients were classified into two groups; neuro ischemic wounds with charcot neuro-arthropathy (30/78) and without charcot neuro-arthropathy (48/78).Atherosclerotic load at the side of diabetic foot was determined by using the Bollinger angiogram scoring method. Comparison of atherosclerotic load between the two groups was performed. The mean of total and infrapopliteal level angiogram scoring of all patients was 33.3 (standard deviation, sd:±17.2) and 29.3 (sd:±15.6), respectively. The mean of total and infrapopliteal level angiogram scoring of neuroischemic wounds with charcot neuro-arthropathy group was 18.1 (sd:±11.6) and 15.7 (sd:±10.4), respectively. The mean of total and infrapopliteal level angiogram scoring of neuroischemic wounds without charcot neuro-arthropathy group was 42.8 (sd:±12.7) and 37.7 (sd:±12.0), respectively. There was a statistically significant difference between the two groups of mean total and infrapopliteal angiogram scoring (p < 0.01). This angiographic study confirms that the atherosclerotic load in patients with diabetic foot and chronic charcot neuro-arthropathy is significantly less than in patients with neuroischemic diabetic foot wounds without chronic charcot neuro-arthropathy.