Publication

Abstract : Diabetic microangiopathy largely affects the infrapopliteal vessels. Extensive infrapopliteal calcification and occlusions, without the presence of collaterals, are common in diabetic patients. When the diabetic patient presents with a nonhealing ulcer, the investigation of first choice should be duplex ultrasound. Ultrasound is not only safe and noninvasive, it also serves to guide further patient management. In a subset of patient in whom intervention is planned, catheter angiogram is the best choice; if the patient has diabetic nephropathy, MR angiogram is an alternative. Multidetector computed tomography angiogram is not a preferred modality in the diabetic patient because there is likely to be extensive calcification in infrapopliteal vessels.