title: Diabetic foot and PAD: the endovascular approach.
abstract: Diabetic foot ulceration (DFU) is recognized as one of the most serious complications of diabetes. Active revascularisation plays a crucial role in achieving ulcer healing. Non-surgical, minimally invasive, revascularisation options for DFU have expanded over the last decade and have become a prominent tool to prevent amputation. Endovascular treatment of arterial DFU lesions is mainly concentrated in the below-the-knee arteries. The outcome of both open surgery and endovascular treatment is broadly spoken the same for the endpoints ulcer healing and limb salvage and is between 78% and 85%. The choice between endovascular treatment and open surgery should always be the outcome of a team discussion. Local expertise plays an important role in these discussions. In many institutions, the endovascular approach has currently become the first choice treatment option. The revascularisation of below-the-knee vessels needs experienced hands, team discussion and the right set of devices. Centralisation in DFU centres is therefore probably the best guaranty for the best outcome.
authors.affiliation: Department of Interventional Radiology, AMC, University Hospital, Amsterdam, The Netherlands. j.a.reekers@amc.uva.nl
authors.forename: J A
authors.initials: JA
authors.lastname: Reekers
authors.forename: J
authors.initials: J
authors.lastname: Lammer
mesh_terms: D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000503:physiopathology* / Q000628:therapy*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D023821:Limb Salvage; D016491:Peripheral Vascular Diseases / Q000517:prevention & control* / Q000601:surgery; D014656:Vascular Surgical Procedures; D014945:Wound Healing