Vascular and Endovascular Review

VOLUME 6, 2023

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

VOLUME 7, 2024

Role of Robotics in Endovascular Surgery: Improving Outcomes in Vascular Interventions

Muhammad Raheel
Department of Business and Management, University of Greenwich, London, UK.

Abstract

Humans have been fascinated by robots for thousands of years, yet the first time a robot was employed in medical was just around 35 years ago. Since then, urology, general surgical specialties, and gynecology have seen a rise in the use of robot-assisted treatments. When it was originally presented in 2002, robot-assisted vascular surgery was believed to address the drawbacks of laparoscopy. It did not, however, become very popular, and only a small number of centers throughout the world currently use it. On the other hand, albeit still in their infancy, robot-assisted endovascular treatments have emerged as a viable substitute for current methods. For vascular and endovascular surgeons, the advancements in robotic technology encourage improved surgical performance and lower workplace risks. Using the search keywords "robotic," "robot assisted," "vascular surgery," and "aortic" for surgical operations or "robotic," "robot assisted," and "endovascular" for endovascular procedures, a thorough literature evaluation was conducted. Included were full-text publications released from 2000 to March 2021. The results, benefits, drawbacks, and viewpoints of the latest advancements in robot-assisted vascular and endovascular surgical procedures are included in this paper.

Keywords : Robotics (RR), Endovascular Surgery (ES), Vascular Interventions (VI).
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Mark Yang
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