Single crural artery angioplasty in healing of ischemic diabetic foot ulcers: a cohort study

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Abstract

Aim
The aim of this study is to show the efficacy of single crural artery angioplasty for diabetic wounds as regard to healing rate, patency rate, mean change in ankle brachial index (ABI), and limb salvage.
Patients and methods
A prospective observational cohort included diabetic patients with critical limb ischemia (Rutherford-5 and 6) who underwent percutaneous infrapopliteal angioplasty for single crural artery. Follow-up for complete wound healing, improving in ABI, patency rate, and limb salvage were done up to 1 year.
Results
In total, 42 patients with median age 56 years (interquartile range=0.06). In total, 27 patients had a diseased single crural artery and 15 patients had lesions in multiple crural arteries. The mean ABI for them was improved significantly after the procedure (=0.0001). Complete wound healing occurred in 31 (73.8%) cases, patency rate at 12 months was 73.8%, and limb salvage rate was 88.1%, we found a significant difference in rate of change in ABI average between the healed group and nonhealed group (=0.006), further analysis using receiver-operating characteristic curve found that the cutoff value of 0.2184 increase in ABI can predict complete wound healing (sensitivity=74.2% and specificity=72.7%).
Conclusion
Single crural artery angioplasty is a safe and effective procedure for management of diabetic patients with ischemic leg ulcers.

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