Editor's Choice - The Intersocietal IWGDF, ESVS, SVS Guidelines on Peripheral Artery Disease in People With Diabetes Mellitus and a Foot Ulcer

被引：26

作者：

Fitridge, Robert ^{[1
]}

Chuter, Vivienne ^{[2
]}

Mills, Joseph ^{[3
]}

Hinchliffe, Robert ^{[4
]}

Azuma, Nobuyoshi ^{[5
]}

Behrendt, Christian-Alexander ^{[6
]}

Boyko, Edward J. ^{[7
]}

Conte, Michael S. ^{[8
]}

Humphries, Misty ^{[9
]}

Kirksey, Lee ^{[10
]}

Mcginigle, Katharine C. ^{[11
]}

Nikol, Sigrid ^{[12
]}

Nordanstig, Joakim ^{[13
]}

Rowe, Vincent ^{[14
]}

Russell, David ^{[15
]}

Berg, Jos C. van den ^{[16
]}

Venermo, Maarit ^{[17
]}

Schaper, Nicolaas ^{[18
]}

机构：

[1] Univ Adelaide, Fac Hlth & Med Sci, Adelaide, Australia

[2] Western Sydney Univ, Sch Hlth Sci, Campbelltown, Australia

[3] Baylor Coll Med, Houston, TX USA

[4] Univ Bristol, Bristol Ctr Surg Res, Bristol, England

[5] Asahikawa Med Univ, Asahikawa, Hokkaido, Japan

[6] Asklepios Med Sch, Dept Vasc & Endovasc Surg, Asklepios Clin Wandsbek, Hamburg, Germany

[7] Univ Washington, Seattle, WA USA

[8] Univ Calif San Francisco, Med Ctr, San Francisco, CA USA

[9] UC Davis Med Ctr, Sacramento, CA USA

[10] Cleveland Clin, Cleveland, OH USA

[11] Univ North Carolina Chapel Hill, Chapel Hill, NC USA

[12] Asklepios Klin, Clin & Intervent Angiol, Hamburg, Germany

[13] Sahlgrens Univ Hosp, Gothenburg, Sweden

[14] UCLA, David Geffen Sch Med, Los Angeles, CA USA

[15] Leeds Teaching Hosp NHS Trust, Leeds, England

[16] Univ Spital Bern Switzerland, Ctr VASCOLARE TICINO Osped Reg Lugano, Sede Civ & Univ Inst Diagnost Intervent & Padiatr, Inselspital, Bern, Germany

[17] Univ Helsinki, Helsinki Univ Hosp, Helsinki, Finland

[18] MUMC, Dept Internal Med, Div Endocrinol, Maastricht, Netherlands

来源：

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY | 2023年 / 66卷 / 04期

关键词：

Chronic limb threatening ischaemia; Critical limb ischaemia; Diabetes mellitus; Diabetes related foot ulcer; Endovascular intervention; Peripheral artery disease; ANKLE-BRACHIAL INDEX; DIRECT-ANGIOSOME REVASCULARIZATION; QUALITY-OF-LIFE; VASCULAR-SURGERY; CLASSIFICATION-SYSTEM; MAJOR AMPUTATION; ISCHEMIC FOOT; ENDOVASCULAR REVASCULARIZATION; EUROPEAN-SOCIETY; BYPASS-SURGERY;

D O I：

10.1016/j.ejvs.2023.07.020

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Diabetes related foot complications have become a major cause of morbidity and are implicated in most major and minor amputations globally. Approximately 50% of people with diabetes and a foot ulcer have peripheral artery disease (PAD) and the presence of PAD significantly increases the risk of adverse limb and cardiovascular events. The International Working Group on the Diabetic Foot (IWGDF) has published evidence based guidelines on the management and prevention of diabetes related foot complications since 1999. This guideline is an update of the 2019 IWGDF guideline on the diagnosis, prognosis, and management of peripheral artery disease in people with diabetes mellitus and a foot ulcer. For this updated guideline, the IWGDF, the European Society for Vascular Surgery, and the Society for Vascular Surgery decided to collaborate to develop a consistent suite of recommendations relevant to clinicians in all countries.This guideline is based on three new systematic reviews. Using the Grading of Recommendations, Assessment, Development and Evaluation framework clinically relevant questions were formulated, and the literature was systematically reviewed. After assessing the certainty of the evidence, recommendations were formulated which were weighed against the balance of benefits and harms, patient values, feasibility, acceptability, equity, resources required, and when available, costs.Through this process five recommendations were developed for diagnosing PAD in a person with diabetes, with and without a foot ulcer or gangrene. Five recommendations were developed for prognosis relating to estimating likelihood of healing and amputation outcomes in a person with diabetes and a foot ulcer or gangrene. Fifteen recommendations were developed related to PAD treatment encompassing prioritisation of people for revascularisation, the choice of a procedure and post-surgical care. In addition, the Writing Committee has highlighted key research questions where current evidence is lacking.The Writing Committee believes that following these recommendations will help healthcare professionals to provide better care and will reduce the burden of diabetes related foot complications.

引用

页码：454 / 483

页数：30

共 148 条

[1]

Aboyans V, 2018, Rev Esp Cardiol (Engl Ed), V71, P111, DOI [10.1016/j.rec.2017.12.014, DOI 10.1016/J.REC.2017.12.014]

[2] 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS [J].