Diabetic Peripheral Arterial Disease
Hofírek I.1, Vojtíšek B.2
1I.interní kardio-angiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc. 2Klinika zobrazovacích metod Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Petr Krupa, CSc. |
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Summary:
Macrovascular impairment of peripheral arteries in diabetes mellitus corresponds with such an
impairment in atherosclerosis. Furthermore, peripheral angiopathy, microangiopathy, and polyneuropathy
resulting from microangiopathy develop in diabetes. Impairment of microcirculation
worsens peripheral blood flow. Infection and insufficient trophism worsen state. A wide range of
factors participate in development of vascular disease in diabetes with adverse influence both on
veins and reactions coming under rheology, haemocoagulation, and immune reactions. In type II
diabetes an average interval of arterial impairment is 9 – 10 years, in type I diabetes approximately
17 – 22 years. A relative risk of non-traumatic amputation of a lower limb in diabetics is several
times higher than in non-diabetics. A prevention of lower limbs impairment in diabetics is the
most efficient method of reducing risk of amputation. An intervention therapy, endovascular
intervention or angiosurgery are indicated in patients with clinical problems. A state of distal bed
is an important factor for success of interventions. As a pivotal drug treatment in intervention
and traditional methods is considered an effective antiaggregation treatment. A diabetic peripheral
arterial disease is a complex disease requiring a wide view and considering various and changing
pathophysiological mechanisms.
Key words:
Diabetes mellitus - Macroangiopathy- Microangiopathy - Endovascular intervention -
Antiaggregation regeneration therapy
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