Surgical Tribune Europe

Vascular occlusions and diabetes—Up to 80 percent of foot amputations can be avoided

By Surgical Tribune
March 27, 2019

MUNICH, Germany- Every year, more than 40,000 feet and legs are amputated due to diabetes. The German Society for Vascular Surgery and Vascular Medicine (Deutschen Gesellschaft für Gefäßchirurgie und Gefäßmedizin) explains that up to 80 percent of these amputations can be avoided by the consistent prevention of foot ulcers and the timely therapy of vascular occlusions. At a press conference for the 136th Congress of the German Society of Surgery (Kongress der Deutschen Gesellschaft für Chirurgie), experts explain where patients affected should go. The congress will take place from 26 to 29 March 2019 in Munich under the motto "Full steam ahead - with heart, hand and mind".

In Germany, more than six million people suffer from diabetes mellitus. "Foot ulcers, from which chronic wounds often develop, are a dreaded secondary disease of the metabolic disorder," says Professor Dr. med. Matthias Anthuber, President of the German Society of Surgery. One in four diabetics develops such a diabetic foot syndrome in the course of their lives, the treatment of which takes up half of all hospital days for diabetes patients. At the same time, diabetic foot syndrome is by far the most frequent cause of amputation. "With more than 40,000 amputations per year, Germany has unfortunately been in the upper echelons of the European market for many years," criticises Professor Dittmar Böckler, President of the German Society for Vascular Surgery and Vascular Medicine. "But with the right measures, the amputation rate could be reduced by up to 80 percent," said the Medical Director of the Department of Vascular Surgery and Endovascular Surgery at the University Hospital in Heidelberg.

In order to avoid amputations, it is crucial to improve the arterial circulation of the affected leg in good time. "Bypass operations and catheter-based minimally invasive methods are available for this purpose, which can both be combined very effectively in so-called hybrid interventions," explained Böckler.

An interdisciplinary treatment team has to decide for each patient on the basis of his or her risk profile which procedure is ultimately suitable. Such a team should include vascular surgeons, but also angiologists, radiologists, general practitioners or diabetologists, orthopaedists as well as non-physician assistants such as podiatrists, specialist nurses for wound treatment, orthopaedic master shoemakers, pain therapists and psychologists.

"We recommend every diabetes patient with foot problems to visit such a centre early", advises vascular specialist Böckler. The same applies to patients suffering from the so-called shop window disease, a severe circulatory disorder in the legs - one in five people over 65 is affected. "Peripheral arterial occlusive disease, which is based on arteriosclerosis, is also associated with an increased risk of amputation," explains Böckler.

Every loss of an extremity has negative effects not only on the quality of life, but also on life expectancy. After a so-called major amputation, i.e. removal of the entire upper and lower leg, only a quarter of diabetes patients survive five years; in the case of minor amputation below the ankle, the figure is 80 percent. "The avoidance of amputations is therefore a top priority in therapy," said Böckler. "Vascular surgeons are an indispensable contact, as they are able to offer all treatment options in many places today".

Professor Böcker will report on this topic at the congress press conference on Friday, 29 March 2019, from 12.00 to 13.00 hrs. The dates of all press conferences are listed below. Accreditation by e-mail at

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