Arterial lesions of the foot vessels in diabetic and non-diabetic patients undergoing lower limb revascularisation.

This study was undertaken to compare the atherosclerotic involvement of the foot arteries in diabetic and non-diabetic patients with leg ischaemia. Ninety-four non-diabetic and 57 diabetic patients were investigated with intraoperative postreconstruction serial angiography during femoro-popliteal and femoro-distal bypass surgery. The foot vessels were evaluated with regard to the anterior and posterior foot arches which were classified as intact, deficient or occluded. Integrity of the pedal circulation was defined as patency of both the anterior and posterior foot arches. Severe involvement of the foot arches was rarely seen in limbs with 3- or 2-lower leg vessel run-off to the foot. The posterior foot arch was more often spared than the anterior foot arch, especially in the non-diabetic group (P less than 0.001). The integrity of the pedal circulation was similar in diabetic and non-diabetic patients (intact in about 20%). Patients with claudication showed a significantly lower occlusion rate of leg and foot arteries than patients with rest pain or gangrene. The results of this study showed that the foot vessels were similarly affected in diabetics and non-diabetics undergoing lower limb revascularization. The same aggressive diagnostic and therapeutic approach should be applied for limb salvage in both groups.