MR angiography illustrates runoff in diabetic patients

May 1, 2008 MR angiography illustrates runoff in diabetic patients Preoperative failure to identify vessels that could be recanalized or used for graft anastomosis may result in unnecessary amputations KARL-FRIEDRICH KREITNER, M.D. -------------------------------------------------------------------------------- Foot complications associated with diabetes are the most common cause of nontraumatic lower extremity amputations in the industrialized world. Research indicates that the risk of lower limb amputation is 15 to 46 times higher in diabetic patients than in those without the disease.1 Common risk factors include peripheral neuropathy, structural foot deformity, infection, ulceration, and peripheral arterial occlusive disease. Diabetic patients are four times more likely than the general population to develop peripheral arterial occlusive disease. This condition typically spares the proximal vessels in diabetic patients and mainly affects the more distal arteries in the calf with long-segment obstructions. These lead to rest pain, ischemic ulcers, toe gangrene, and osteomyelitis (Figure 1). Diabetic patients are consequently five times more likely to develop critical limb ischemia than the nondiabetic population.1-3

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