Background. Ischemia of the lower extremity is the strongest risk factor of limb loss in patients with diabetic foot. The main purpose of this study was the evaluation of the feasibility and the early results of revascularisation in that group of patients.
Material and methods. A group of 120 patients with ischaemic diabetic foot (IDF) was analysed. The inclusion criteria were an ulcerated or necrotic foot, an absence of pulse on at least both foot arteries and diagnosed diabetes. Patients with deep infection in the foot requiring urgent surgical intervention were excluded. All patients underwent lower extremity arteriography. The decision about further treatment was based on the results of arteriography.
Results. In arteriography, diffuse atherosclerotic lesions in the femoro-popliteo-tibial segment dominated (71.6%). Aorto-iliac occlusive disease (16.6%) and isolated changes in the tibial arteries (11.6%) were less frequently observed. Femoro-popliteal bypass grafting was feasible in half of the patients, 18% of patients required distal grafts and 16% had the operations in the aorto-iliac segment. In 11% of the cases, because of lack of possibilities of revascularisation, patients were disqualified from surgery. The early limb salvage rate was 93.91 and 64% for the aorto-iliac, the femoro-popliteal and femoro-distal revascularisation, respectively. Almost all of the non-operated patients lost the lower limb.
Conclusion. The surgical revascularisation, mainly femoro-popliteal and femoro-distal grafts are feasible and effective in the treatment of IDF.