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The main goal of this Multidisciplinary School is to support clinicians to develop specific competencies in order to deal with and manage critical limb ischemia and diabetic foot disorders, to reinforce specific skills for selecting and applying appropriate revascularization techniques in critical limb ischemia treatment, tailoring the intervention according to lesion type and revascularization targets.

The increased knowledge of the clinical manifestations and pathophysiology of these diseases together with the specific interventional approaches will enable the learner to prevent delayed and incorrect diagnosis by selecting the appropriate treatment approach and to adopt well-time and patient-tailored strategies. 

In this course, we will propose in the first unit a decision flow chart for choosing the best revascularization strategy in diabetic patients with critical limb ischemia. In the second unit, we will summarize our experience in endovascular treatment of diabetic critical limb ischemia, focusing on the main technical challenges in treating below-the-knee vessels. 

 

                          Table of videos


UNIT I : Critical Limb Ischemia in diabetic patients

 Big & small vessels: the new scenario of PAD
 Symptoms of PAD and interventional approach
 DM & non-DM manifestations of PAD
 Multidisciplinary approach in diabetic foot
 Diabetic foot triage
 Angioplasty first strategy
 Rutherford 4
 Rutherford 5
 Rutherford 6.1
 Rutherford 6.2
 

UNIT II : Revascularization strategy and technique in diabetic critical limb ischemia

Chapter I
Radiological study and anatomical variations of BTK & FOOT vessels
 Radiological study
 Anatomical variability

Chapter II
Revascularization strategy and technique
 Targets in CLI revascularization
 Antegrade femoral approach
 Step-by-step approach in CTOs crossing strategy
 Endoluminal approach
 Subintimal approach
 Retrograde approach
 Acute result optimization
 Prevention of restenosis


Procedures

 Angioplasty of anterior tibial artery and dorsalis pedis in a « desert foot »
 Popliteal artery stenosis in patient with leg ulcer
 DEB treatment of a focal popliteal lesion
 DEB treatment of a focal popliteal lesion
 Calcified SFA stenting in claudication
 Popliteal artery angioplasy and posterior tibial recanalization
 Multiple BTK recanalization in a challenging patient
 Superfical femoral artery, retrograde recanalization
 Unmet clinical needs in BTK

 

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About Roberto Ferraresi


- Interventional Cardiology

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Contributors

Roberto Ferraresi , Bergamo, Milano, Italy

Learning Points:

- Recognize the different obstructive patterns of atherosclerotic disease in diabetic and non-diabetic patients

- Evaluate the different interventional approach in claudication and in critical limb ischemia, applying the correct revascularization strategy and pursuing the correct vascular targets

- Learn the key-points and necessary steps to establish a multidisciplinary team and a diabetic foot clinic

- Distinguish different targets in percutaneous revascularization strategy

- Learn/Perform/Practice a variety of revascularization techniques to be applied in critical limb ischemia management

- Evaluate the problem of prevention of restenosis considering the studies on below-the-knee vessel stenting and how restenosis affects wound healing

 

 

 

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