Rambam prevents ‘diabetic foot’ amputations

Rambam Medical Center in Haifa said on Sunday that in the last two years, it has saved the limbs of 521 such patients by performing “leg catheterizations” that supply blood to the limb and keep it alive.

World Diabetes Day will be marked around the world to increase awareness of Type II Diabetes, which affects many millions of people around the globe and is largely due to improper eating, obesity and lack of exercise.

Amputation of a foot or leg used to be common among Israelis with complications from uncontrolled diabetes, with about 1,000 such operations a year.

Diabetics with complications may suffer from “diabetic foot” – sores that are difficult to heal and cause the limbs to deteriorate and turn gangrenous, requiring amputation.

But catheterization makes it possible to renew blood supply and prevent or treat infections, and the procedure can be repeated if the problem returns, Rambam doctors said.

Rambam radiologists and interventional cardiologists have undergone special training to perform the procedure, which is available in only a few medical centers in the world. Dr. Igor Kogan, a senior interventional cardiologist and head of the radiological endovascular service at the Haifa hospital, studied the technique abroad with the aim at removing blockages in the vessels of the legs. He is one of the few physicians in Israel able to perform it.

Kogan said that the increase in such procedures is due to better awareness among diabetologists and other specialists that legs do not necessarily have to be amputated.

More experience makes it possible for them to save legs that were hopeless cases before, he added.

Leg catheterization is very delicate work, as the blood vessels are only a few millimeters in diameter. A tiny inflatable balloon is pushed into the blood vessels and inflated to open them so blood flow can resume and reach as far as the bottom of the foot. The procedure, in which orthopedics, plastic surgeons and endrocrinologists are also involved, takes about two-and-a-half hours and requires only sedation and local anesthesia.

After one day’s hospitalization, the patient is discharged.

Rambam is one of the few centers that use carbon dioxide rather than iodine in the procedure so that patients with kidney problems who are sensitive to iodine will not be harmed.