Effectiveness of Angioplasty in Treatment of Diabetic Foot Patients with Infragenicular Multiple Stenosis or Occlusion: A Prospective Study

Backgound: Diabetic foot is one of the most serious and debilitating consequences of diabetes, and it is described as an ulcerated foot in a diabetic patient with neuropathy and/or peripheral artery disease of the lower limb. Diabetic foot ulceration affects 4–10% of diabetic patients, with the condition affecting older patients more frequently.
Objectives:  In this study, we aimed to assess the effectiveness of angioplasty in the treatment of diabetic foot patients with infragenicular multiple stenosis or occlusion.
Patients and Methods: We performed a prospective cohort investigation that recruited diabetic patient with infragenicular critical limb ischemia (CLI) with or without supragenicular lesion at Vascular Surgery Department in Aswan University Hospital through the period from January 2019 to June 2020. 20 patients were included if they were older than 18 years old, diabetic, had diabetic foot, and had confirmed diagnosis of CLI.
Results: Seventeen patients (85%) had immediate success, they remained patent after one month. After three and six months, 14 patients (70%) and 13 (65%) remained patent, respectively (p >0.05). With regard to limb salvage by the end of six months, 15 patients (75%) had limb salvage in the form of rest pain relief in 3/4 patients (75%), minor ulcer healing in 10/10 patients (100%), and healing of tissue after debridement or minor amputation 2/6 patients (33.3%). The remaining five patients had non-salvaged limbs. As regarding amputations, three patients (15%) underwent major amputation. A total of four patients (20%) had complications.
Conclusion: In conclusion, infragenicular angioplasty exhibited efficacy in CLI management in diabetic patients, with an acceptable patency rate and safety profile.