title: Endovascular treatment of critical ischemia in the diabetic foot: new thresholds, new anatomies.
abstract: This review discusses the role of endovascular treatment in diabetic patients with critical limb ischemia (CLI). Angioplasty of the femoropopliteal region achieves similar technical success and limb salvage rates in diabetic and nondiabetic patients. Angioplasty in as many as possible tibial vessels is accompanied by more complete and faster ulcer healing as well as better limb salvage rates compared to isolated tibial angioplasty. Targeted revascularization of a specific vessel responsible for the perfusion of a specific ulcerated area is a promising new approach: it replaces revascularization of the angiographically easiest-to-access tibial vessel, even if this is not directly responsible for the perfusion of the ulcerated area, by revascularization of area-specific vascular territories. In conclusion, the endovascular approach shows very high efficacy in ulcer healing for diabetic patients with CLI. Larger prospective studies are now needed to estimate the long-term results of this approach.
authors.affiliation: 1Department of Vascular Surgery, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Georgakarakos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanas
authors.forename: Evaggelia
authors.initials: E
authors.lastname: Papadaki
authors.forename: George S
authors.initials: GS
authors.lastname: Georgiadis
authors.forename: Efstratios
authors.initials: E
authors.lastname: Maltezos
authors.forename: Miltos K
authors.initials: MK
authors.lastname: Lazarides
mesh_terms: D017130:Angioplasty; D015897:Comorbidity; D017719:Diabetic Foot / Q000453:epidemiology*; D057510:Endovascular Procedures; D006801:Humans; D007511:Ischemia / Q000453:epidemiology* / Q000601:surgery*; D023821:Limb Salvage; D016491:Peripheral Vascular Diseases / Q000453:epidemiology; D015607:Stents; D013848:Thigh / Q000098:blood supply; D014654:Vascular Patency; D014945:Wound Healing
keywords: angiosome; critical limb ischemia; diabetes; endovascular; ulcer; wound healing