Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000200010
Jornal Vascular Brasileiro
Case Report

Angioplastia subintimal sem o uso de stent em paciente diabético portador de lesão complexa no pé

Subintimal angioplasty without stenting on a patient with complex foot lesion

Bernardo Massière; Cleoni Pedron; Arno von Ristow; José Mussa Cury; Marcus Gress; Alberto Vescovi; Marcos Areas Marques; Antonio Luiz de Medina

http://dx.doi.org/10.1590/S1677-54492008000200010 J Vasc Bras, vol.7, n2, p.155-158, 2008
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Resumo

Pacientes diabéticos portadores de doença ateroesclerótica obliterativa periférica e lesões complexas de partes moles são freqüentemente tratados por amputação primária. Os autores relatam o caso de paciente de 66 anos, sexo feminino, portadora de múltiplas comorbidades, apresentando volumoso abscesso plantar esquerdo e lesão femoral superficial conforme TASC C. Optou-se por realizar revascularização endovascular do membro inferior esquerdo por técnica de angioplastia subintimal sem o emprego de stent ou endoprótese. A abordagem combinada de revascularização endovascular do membro inferior associada a cuidados intensivos com feridas de pés diabéticos deve sempre ser considerada antes da amputação. Assim, sugere-se a técnica de angioplastia subintimal como uma opção em pacientes de elevado risco cirúrgico portadores de feridas complexas nas extremidades.

Palavras-chave

Angioplastia subintimal, membro inferior, pé diabético

Abstract

Diabetic patients presenting with both peripheral vascular disease and complex soft-tissue defects are often treated by primary amputation. We report the case of a 66-year-old female patient with multiple comorbid conditions. She presented left foot plantar abscess and TASC C superficial femoral lesion. Endovascular revascularization of the left lower limb was performed employing the subintimal angioplasty technique, without stenting or endografting. This combined approach of lower limb revascularization associated with intensive care in diabetic foot wounds should always be considered before amputation. We recommend subintimal angioplasty as an option for high-risk patients with complex limb wounds.

Keywords

Subintimal angioplasty, lower limb, diabetic foot

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