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Title: Macrovascular and microvascular disease in diabetic foot disease
Author: Lowry, Danielle Lylie
ISNI:       0000 0004 9358 6687
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2019
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The objective was to examine how diabetes mellitus (DM) impacts the arterial system of the lower limbs by assessing both macrovascular disease and the microvascular function. A retrospective cohort study assessed the distribution of disease on digital subtraction angiography in 306 patients, half with DM. The Bollinger score was applied to all infra-inguinal vessels seen. There was a trend towards patients with DM having a higher burden of disease throughout the infra-inguinal arterial tree. When divided by indication for procedure patients without DM had more disease in the pedal vessels. Secondly, in a prospective study, 24 patients with active foot ulceration were recruited and grouped as having no significant arterial disease (n=14) and those requiring percutaneous angioplasty (PCA, n=10). Laser Doppler fluxmetry (LDF) assessed the microcirculation at regular intervals until healing. Using LDF, the time to maximum flux significantly reduced following PCA, in those that healed (210.5s (72.18-231) to 50.71s (27.38-105.18) p=0.046). The microcirculation is suggested to improve following PCA; further research is required to explore how changes in the macrocirculation relate to the microcirculation particularly in patients with DM.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: R Medicine (General) ; RD Surgery