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The British Journal of Diabetes & Vascular Disease
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Review: The management of tibial artery disease in diabetes

Francesco Torella

Department of Vascular Surgery, South Manchester University Hospital

Ray J Ashleigh

Radiology, South Manchester University Hospital

Amman Bolia

Department of Radiology, Leicester Royal Infirmary

Akhtar Nasim

Department of Vascular Surgery, South Manchester University Hospital, Akhtar.Nasim{at}smuht.nwest.nhs.uk

Foot ulceration and gangrene are important causes of morbidity in diabetic patients. Healing of such lesions requires surgical debridement of the infected and necrotic tissue, and restoration of pulsatile blood flow to the foot. As occlusive atherosclerosis of the tibial arteries is particularly common in diabetic patients, infrapopliteal revascularisation is often required. This has traditionally been accomplished by transluminal angioplasty or surgical bypass, with moderately good results. More recently, subintimal angioplasty has been proposed as an alternative, minimally invasive treatment to recanalise long arterial occlusions, with promising patency rates even in small vessels. Advanced reconstructive techniques, including local or free tissue flaps can be used to accelerate healing of large foot wounds after successful revascularisation. Treatment of diabetic tibial artery disease is challenging and requires an aggressive multidisciplinary approach, with co-operation between diabetologists, interventional radiologists, vascular and plastic surgeons.

Key Words: diabetes mellitus • peripheral vascular disease • angioplasty • arterial bypass.

The British Journal of Diabetes & Vascular Disease, Vol. 2, No. 3, 162-166 (2002)
DOI: 10.1177/14746514020020030301
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 British Journal of Diabetes & Vascular DiseaseHome page
A. J Krentz, R. Mani, and C. P Shearman
Review: Peripheral arterial disease in diabetes: time for a co-ordinated approach to management
The British Journal of Diabetes & Vascular Disease, March 1, 2003; 3(2): 92 - 96.
[Abstract] [PDF]