Abstract:

Aim: was to evaluate frequency and features of pedal arteries lesions in diabetic patients with critical limb ischemia (CLI).

Materials and methods: a retrospective review of feet angiograms of 144 diabetic patients with ischemic ulcer-necrotic lesions was performed. We evaluated rate of different variants and features of pedal arterial lesions. Also, we analyzed lesion characteristics of the source artery and the frequency of the plantar arch occlusion.

Results: 219 hemodynamically significant lesions were detected, 179 of which were occlusions (82%). The majority of occlusions (140(78%)) were an extension of tibial arterial lesions. The rate of occlusions of more than 5 cm in length was 86%(154). There were no passable vessel segments in 38 cases (21% of occlusions). Single-vessel occlusive disease was revealed in 67 patients (46%), double-vessel defeat - in 56 (39%) patients. The source artery occlusion was observed in 110 cases (76%). In 92% of cases the length of the source artery occlusion was more than 5 cm. The occlusion of a non-feeding artery was found in 69 cases (48%). The plantar arch occlusion was revealed in 37 patients (26%).

Conclusion: in diabetic patients with CLI the arterial lesion of the foot is predominantly establishec by long occlusions, often with two-vessel involvement. The most often occluded vessel is a feeding artery It explains difficulties with the direct revascularization. The plantar arch is occluded in one quarter of cases. 

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