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Diagnosis and assessment of peripheral arterial disease in the diabetic foot
Author(s) -
Brownrigg J. R. W.,
Schaper N. C.,
Hinchliffe R. J.
Publication year - 2015
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12749
Subject(s) - medicine , arterial disease , peripheral , amputation , revascularization , diabetes mellitus , vascular disease , diabetic foot , disease , diabetic foot ulcer , cardiology , perfusion , peripheral neuropathy , surgery , myocardial infarction , endocrinology
Abstract Approximately half of all patients with a diabetic foot ulcer have co‐existing peripheral arterial disease. Identifying peripheral arterial disease among patients with foot ulceration is important, given its association with failure to heal, amputation, cardiovascular events and increased risk of premature mortality. Infection, oedema and neuropathy, often present with ulceration, may adversely affect the performance of diagnostic tests that are reliable in patients without diabetes. Early recognition and expert assessment of peripheral arterial disease allows measures to be taken to reduce the risk of amputation and cardiovascular events, while determining the need for revascularization to promote ulcer healing. When peripheral arterial disease is diagnosed, the extent of perfusion deficit should be measured. Patients with a severe perfusion deficit, likely to affect ulcer healing, will require further imaging to define the anatomy of disease and indicate whether a revascularization procedure is appropriate.