Background: Peripheral Arterial Disease (PAD) is a condition characterized by atherosclerotic occlusion of arteries of the lower extremities. In patients with type 2 diabetes, PAD is a risk factors for the development of Diabetic Foot Ulcers (DFU). Computed Tomography Angiography (CTA) can be used for the evaluation of PAD. PAD can be treated with Percutaneous Transluminal Angioplasty (PTA) or pharmacological treatments.

Objective: We aimed at testing the association between PAD and DFU in a cohort of type 2 diabetic patients followed at the Shandong Provincial Hospital. Moreover, we aimed at evaluating the role of CTA for the diagnosis of PAD and for the prediction of DFU. Furthermore, we aimed at assessing the DFU outcome of the PTA treatment.

Patients, Methods, and Results: A total of 523 type 2 diabetics were evaluated for PAD. The overall prevalence of PAD was 59.5%. Among patients with PAD, 95 had DFU and 22 of them (23.2%) received an amputation after one year. A group of 62 patients with DFU and PAD was further investigated. A subgroup of these 62 patients was treated with PTA (PTA group) while the other subgroup was treated with pharmacological treatment (control group). In the PTA group, 18 (82%) of the patients showed a remarkable improvement of symptoms. Compared to controls, PTA-treated patients healed their DFU faster, with a difference of 20±5 days. Lastly, the amputation and recurrence rates of DFUs after one year were 6.0% and 8.0% in the PTA group, respectively, compared to 16.0% and 17.6% in the control group.

Conclusions: We conclude that the angiographic analysis could help in the diagnosis of PAD and prediction of DFU, as severe PAD is positively correlated to DFU. Moreover, the PTA treatment of PAD could significantly shorten the time of DFU healing and decrease the rate of ulcer recurrence.