Carbon Dioxide Angiography and Clinical Eligibility Scale for Endovascular Interventions in Neuroischemic Diabetic Foot Syndrome with Chronic Kidney Disease: A Comparative Cohort Study
- DOI
- 10.2991/978-94-6463-984-1_18How to use a DOI?
- Keywords
- diabetic foot syndrome; chronic kidney disease; carbon dioxide angiography; endovascular intervention; limb salvage
- Abstract
Neuroischemic diabetic foot syndrome (DFS) in patients with chronic kidney disease (CKD) represents one of the most severe and prognostically unfavorable clinical scenarios, where the use of traditional iodinated contrast angiography is often limited by the risk of contrast-induced nephropathy. This leads to reduced rates of revascularization and high amputation frequency. This research amis to evaluate the effectiveness and safety of a differentiated endovascular strategy based on carbon dioxide angiography (CO₂A) and an original Clinical Eligibility Scale for Endovascular Interventions (CES-EVI) in patients with neuroischemic DFS and CKD. A total of 114 patients with neuroischemic DFS and CKD were included. The control group underwent standard diagnostic and surgical management with limited angiography. The main group received individualized treatment guided by CES-EVI and CO₂A. Patients were stratified by CKD stage (G1-G3a vs G3b-G5). Clinical assessment included metabolic, laboratory, microbiological, and angiographic evaluation. Primary outcomes were feasibility of endovascular interventions, limb salvage (anatomical and functional), renal safety, and 6-month mortality. The result shows that in the control group, revascularization was feasible in only 27.3% of cases, with high rates of major amputations (up to 52.4% in CKD G3b-G5) and renal deterioration after angiography (23.8%). In contrast, the main group achieved 100% feasibility of revascularization through CES-EVI stratification and CO₂A in 71.2% of patients. Major amputation rates were reduced 2.5–3 times, renal impairment after angiography decreased sevenfold, and limb salvage improved both anatomically (up to 100% in G1-G3a, 58.6% in G3b-G5) and functionally (100% and 72.4%, respectively). Six-month mortality was nearly halved compared to controls. The integration of CO₂ angiography and CES-EVI provides a nephro-safe, individualized approach for patients with neuroischemic DFS and CKD. This strategy significantly increases the feasibility of revascularization, reduces major amputations and postoperative complications, and improves both renal safety and survival.
- Copyright
- © 2025 The Author(s)
- Open Access
- Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
Cite this article
TY - CONF AU - Telman T. Kamalov AU - Sardorbek S. Begmetov PY - 2025 DA - 2025/12/26 TI - Carbon Dioxide Angiography and Clinical Eligibility Scale for Endovascular Interventions in Neuroischemic Diabetic Foot Syndrome with Chronic Kidney Disease: A Comparative Cohort Study BT - Proceedings of the Turakulov Readings 2025 Conference (TR 2025) PB - Atlantis Press SP - 173 EP - 182 SN - 2468-5739 UR - https://doi.org/10.2991/978-94-6463-984-1_18 DO - 10.2991/978-94-6463-984-1_18 ID - Kamalov2025 ER -