Vascular surgical therapy of diabetic foot syndrome@@@Gefäßchirurgische Therapie des diabetischen Fußsyndroms

The number of diabetic patients in Germany is rising, currently totalling more than 6 million. Due to neuropathic and angiopathic long-term damage the number of patients with "diabetic foot syndrome" has been increasing dramatically in recent years, and continues to do so. Every year, more than 150,000 diabetics develop a foot ulcer that often heals slowly and therefore becomes a chronic wound. Despite intensive preventive efforts on the part of the individual medical specialties, early diagnosis and adequate therapy, there are more than 20,000 diabetics undergoing major limb amputation in Germany every year. A large number of these amputations could be avoided if an improvement of arterial perfusion were to be considered earlier in the course of a multidisciplinary treatment approach. With consistent therapy in interdisciplinary centres, and by applying all methods of arterial revascularization, the amputation rate in patients with diabetic foot problems could be reduced by 80%.This article describes the pathogenesis, diagnostics and therapy of the diabetic foot syndrome from a vascular surgical point of view. The importance of endovascular, vascular-surgical as well as combined (hybrid) procedures of revascularization is emphasized.