Diabetic foot · Germany · 1,192 patients · two hospitals, same years
4.6×
fewer major amputations with a structured diabetic foot service
Weck et al. Cardiovasc Diabetol 2013. doi:10.1186/1475-2840-12-45
Limb salvage team in Moscow
KINK.RF is a multidisciplinary team for patients with chronic limb-threatening ischemia and diabetic foot. KINK is the Russian acronym for critical lower limb ischemia.
- 20 yearsof work with threatened limbs
- 5,500patients
- 8,000procedures on leg arteries
- JSC «Medicine»inpatient hospital in Moscow, JCI accredited
What we do
Many of our patients come after they have been offered a major amputation, or after a revascularization that did not heal the wound.
One lead surgeon owns the decision and calls in the others. Each leg gets its own strategy, chosen from the full range of tools - the effective one, not the most beautiful one.
Patients come to us from all over Russia, so the team follows them before arrival and after discharge. Inpatient care - JSC «Medicine», Moscow.
- Endovascular revascularization below the knee and in the foot, including atherectomy and lithotripsy for heavy calcification
- Open and hybrid vascular surgery
- Deep venous arterialization for patients with no other option
- Wound surgery and wound care until the wound has closed
- Cardiac assessment: we look for myocardial ischemia at rest and do not stent coronaries “just in case”
- The discharge prescription as part of the procedure: antithrombotic and lipid-lowering therapy
Where the patient is treated matters
No randomised trial has compared a specialised service with usual care, and none is likely to be run. But wherever a dedicated team took over, major amputations fell several-fold.
Diabetic foot · Copenhagen, Denmark · population 178,000
3.9×
fewer major amputations after a multidisciplinary foot clinic opened and revascularizations rose sevenfold
Holstein et al. Diabetologia 2000. doi:10.1007/s001250051459
All indications, including CLTI · Seattle, USA
4.1×
fewer major amputations after a limb preservation service was set up
CLTI alone: 68% fewer.
Hemingway et al. Ann Vasc Surg 2021. doi:10.1016/j.avsg.2020.08.001
Observational studies - before-after or non-randomised comparison: an association, not proof of cause. The multiples are our calculation from the published figures.
The team
Andrey Eroshenko, MD, PhDHead of the team; cardiovascular and endovascular surgeon
Ivan Eroshkin, MD, PhDEndovascular surgeon, lower limb arterial interventions
Ekaterina Zubova, MD, PhDCardiologist, cardiac intensive care, functional diagnostics
Galina Strakhova, MD, PhDEndocrinologist and podiatrist; head of the Diabetic Foot Competence Centre; associate professor, Department of Endocrinology and Diabetology, Pirogov Russian National Research Medical University
Nadezhda Maksimova, MD, PhDEndocrinologist and podiatrist; associate professor, Department of Endocrinology and Diabetology, Pirogov Russian National Research Medical University
Alexander Kharazov, MD, PhDVascular surgeon, open and hybrid surgery
Alexey Kovylov, MDSurgeon, wounds and wound infection
Vitaly Tsvetkov, MD, PhDSurgeon, wounds and wound infection
Seventeen specialists in total - full team on the Russian site.
Teaching and science
KINK-2026 course, Moscow.
- CLTI (KINK) conference
Held every year, with more than 700 participants at each conference. The 2027 conference will be the 11th. CLTI (KINK) Conference 2027, 26-27 February →
- Professional society
Association “National Scientific Society of Specialists in the Treatment of Critical Lower Limb Ischemia” - registered association since 2021. Website in Russian: nno-kink.ru
- Guidelines in Russian
Russian edition of the Global Vascular Guidelines on the management of CLTI, 2019 - with permission of ESVS and Prof. M.S. Conte.
- Talks abroad
CEC-2026, Shanghai: “Beyond Revascularization - Towards Specialized Care for CLTI”.
- Selected publications
-
- Eroshenko An.V., Eroshkin I.A., Zubova E.A., Kovylov A.O., Krasnoshchekova L.S. Endovascular arterialization of deep crural and pedal veins in a patient with critical lower limb ischaemia. Angiology and Vascular Surgery. 2021; 27(3): 54-65. doi:10.33529/ANGIO2021317
- Eroshenko An.V., Minushkina L.O., Eroshkin I.A., Zubova E.A. Revascularization or conservative therapy for intermittent claudication: a systematic review and meta-analysis of clinical trials with a follow-up period of 5 years or more. International Journal of Interventional Cardioangiology. 2024; (76): 45-74. doi:10.24835/1727-818x-76-45
Two documents we use ourselves
Checklist: what makes a limb salvage centre
PDF, 2 pages
28 questions across six areas: team, wound, heart, drugs, technology, knowledge. No randomised trial has compared a specialised centre with usual care, so this is a map of gaps, not a certificate. A centre with every box ticked does not exist - ours does not either.
Download the checklist (PDF)Outcome form: the minimum dataset for CLTI
PDF, 2 pages
One line per patient, four points in time, agreed definitions. It stays with you: we do not collect anything. Four numbers change a centre - limb salvage, wound healing, survival, and how many patients left on the right drugs.
Download the outcome form (PDF)Contact the team
For colleagues: case discussion, patient referral, lecture invitations, joint projects, CLTI (KINK) Conference 2027. We reply in English or Russian.
- Telegram
@kinkru - WhatsApp
+7 915 192-76-40
JSC «Medicine»Inpatient care for KINK.RF patients
Accredited by Joint Commission
International
International
10, 2nd Tverskoy-Yamskoy Lane, Moscow
Mayakovskaya metro station - about 7 minutes on foot