Lower limb ischaemia in patients with diabetic foot ulcers and gangrene: Recognition, anatomic patterns and revascularization strategies

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

The confluence of several chronic conditions - in particular ageing, peripheral artery disease, diabetes, and chronic kidney disease - has created a global wave of lower limbs at risk for major amputation. While frequently asymptomatic or not lifestyle limiting, at least 1% of the population has peripheral artery disease of sufficient severity to be limb threatening. To avoid the critical error of failing to diagnose ischaemia, all patients with diabetic foot ulcers and gangrene should routinely undergo physiologic evaluation of foot perfusion. Ankle brachial index is useful when measurable, but may be falsely elevated or not obtainable in as many as 30% of patients with diabetic foot ulcers primarily because of medial calcinosis. Toe pressures and skin perfusion pressures are applicable to such patients.

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalDiabetes/Metabolism Research and Reviews
Volume32
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Keywords

  • Angioplasty
  • Critical limb ischaemia
  • Diabetic foot ulcer
  • Limb-threatening ischaemia
  • Lower extremity bypass
  • PAD in diabetes
  • Revascularization

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

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