FEASIBILITY AND EFFECTIVENESS OF PERIPHERAL PERCUTANEOUS TRANSLUMINALBALLOON ANGIOPLASTY IN DIABETIC SUBJECTS WITH FOOT ULCERS

OBJECTIVE - The aim of this study was to evaluate the feasibility and effectiveness of this vascular procedure in diabetic inpatients with f oot ulcers. RESEARCH DESIGN AND METHODS - In 80 consecutive inpatient diabetic subjects with a foot ulcer, an angiographic study of the lowe r limbs was carried out to evaluate the necessity and possibility of p erforming vascular procedures. In 22 subjects, vascular procedure was not necessary; in 26 subjects, peripheral transluminal angioplasty was carried out; in 10 subjects, angioplasty was considered impossible an d a peripheral bypass graft was performed; and in 22 subjects, no vasc ular procedure was considered possible. RESULTS - Of the 26 angoplasti es, 8 were performed in iliac or femoral arteries and 18 were performe d in the popliteal artery and its branches. The angioplasty was consid ered unsuccessful in 4 subjects and successful in 22. After angioplast y, on discharge, parameters of limb perfusion improved significantly: transcutaneous oxygen tension was 27.0 +/- 14 mm/Hg on admission and 4 4.6 +/- 14 mm/Hg on discharge (P < 0.001); ankle-brachial index was 0. 61 +/- 0.23 on admission and 0.77 +/- 0.20 on discharge (P = 0.018). O f 22 subjects who underwent successful angioplasty, 21 ended the follo w-up of 12 months: during this period, they showed no relapses in the salvaged limb, and their parameters of limb perfusion did not signific antly vary. CONCLUSIONS - Angioplasty is feasible in a large percentag e of diabetic subjects with peripheral occlusive arterial disease and foot ulcer and is often also practicable in the popliteal artery and i ts branches. In these subjects, angioplasty significantly improves the parameters of limb perfusion. Angioplasty is therefore an important t herapeutic tool in ulcerated diabetic foot care.