Is Angiosome-Targeted Angioplasty Effective for Limb Salvage and Wound Healing in Diabetic Foot? : A Meta-Analysis

• Published in: PloS one Vol. 11; no. 7; p. e0159523
• Main Authors: Chae, Kum Ju, Shin, Jin Yong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21.07.2016; Public Library of Science (PLoS)
• Subjects: Aged; Analysis; Angioplasty; Bias; Biology and Life Sciences; Blood Vessels - pathology; Care and treatment; Diabetes mellitus; Diabetic foot; Diabetic Foot - pathology; Diabetic Foot - therapy; Feet; Foot diseases; Humans; Limb Salvage; Literature reviews; Medical ethics; Medicine and Health Sciences; Meta-analysis; Middle Aged; Physical Sciences; Physiological aspects; Publication Bias; Quality assessment; Research and Analysis Methods; Salvage; Studies; Systematic review; Veins & arteries; Wound Healing; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0159523

Given that the efficacy of employing angiosome-targeted angioplasty in the treatment of diabetic foot remains controversial, this study was conducted to examine its efficacy. We performed a systematic literature review and meta-analysis using core databases, extracting the treatment modality of angiosome-targeted angioplasty as the predictor variable, and limb salvage, wound healing, and revision rate as the outcome variables. We used the Newcastle-Ottawa Scale to assess the study quality, along with the Cochrane Risk of Bias Tool. We evaluated publication bias using a funnel plot. The search strategy identified 518 publications. After screening these, we selected four articles for review. The meta-analysis revealed that overall limb salvage and wound healing rates were significantly higher (Odds ratio = 2.209, 3.290, p = 0.001, p<0.001) in patients who received angiosome-targeted angioplasty than in those who received nonangiosome-targeted angioplasty. The revision rate between the angiosome and nonangiosome groups was not significantly different (Odds ratio = 0.747, p = 0.314). Although a further randomized controlled trial is required for confirmation, angiosome-targeted angioplasty in diabetic foot was more effective than nonangiosome-targeted angioplasty with respect to wound healing and limb salvage.