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Subject Area

Otorhinolaryngology

Article Type

Original Study

Abstract

Background Endovascular techniques have undergone major advances with regard to the treatment of infrapopliteal arterial occlusive disease. Objective The objective of this study was to determine angiographic characteristics of infrapopliteal arterial lesions that are dependent predictors of endoluminal revascularization in diabetic patients with ischemic foot ulcers. Patients and methods The present study included 64 patients with ischemic diabetic foot ulcers who were admitted to the vascular surgery unit at Gamal Abdel Naser Hospital (Alexandria) during October 2014–December 2015. Informed consent was obtained from all patients. Patients underwent angioplasty and were followed-up for an average of 12 months. The clinical and procedural data of all included patients were collected. Preprocedural and postprocedural angiographic images were reviewed to classify lower-limb arterial involvement according to the Joint Vascular Society Council classification of calf and foot scores. Foot lesions were graded according to The University of Texas wound classification system. Clinical results (healing, nonhealing, or major amputation) were compared with baseline clinical data and angiographic results using Student's t test. All statistical analyses were performed using SAS software. Results During the study period, 64 percutaneous procedures were performed, with an immediate technical success rate of 89.8%. Before the procedure, the mean ± SD calf and foot scores were 7.8 ± 1.6 and 7.3 ± 2.3, respectively. After the procedure, the mean calf and foot scores were 4.8 ± 2.3 and 5.9 ± 2.6, respectively. The limb salvage rate was 87%, and the major amputation rate was 9.4%. Among all the clinical and angiographic variables included in the analysis, only preprocedural and postprocedural foot scores were significantly associated with the clinical outcome (P < 0.05). Conclusion Preprocedural and postprocedural foot scores represent the most significant angiographic parameters to evaluate chances for ulcer healing, and consequently to determine the success of the revascularization procedure.

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