Cultura

Narratives of Sustainability in the Anthropocene. Interdisciplinary Dimensions

VOLUME 20, 2023

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Asun LÓPEZ-VARELA AZCÁRATE
Universidad Complutense de Madrid, Spain

Abstract

In his bestseller Sapiens: A Brief History of Humankind (2015), Yuval Noah Harari noted that one of the most important cognitive faculties in the human species is the development of imagination, a faculty that, together with human capability for establishing cause-effect relationships and turning them into stories, has enabled the creation of narratives. But according to Harari, the importance of narrative not only lies on being able to tell about things that take place around us. “Rather, it’s the ability to transmit information about things that do not exist at all. As far as we know, only Sapiens can talk about entire kinds of entities that they have never seen, touched or smelled.” (24) This means that humans can create unique forms of social organization beyond the present; that is, envisioning not only the past, as in myths, but also the future, as in all the religious narratives that foresee life after death.

Keywords : human species, Sapiens.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty