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Article Type

Original Study

Abstract

Aim We designed the study for determining if ankle peak systolic velocity (APSV) has value in prediction of healing in diabetic foot lesions in patients with critical lower limb ischemia. APSV is the mean of the peak systolic velocities estimated at the ankle level over the distal tibial arteries. Patient and Methods Patients were included if they had diabetes foot lesions. Such lesions were ulcers, gangrene, or tissue necrosis. In addition, they had nonpalpable pedal pulses. Endpoints were healed or healing foot lesions, revascularization, major amputation, or death. Fifty diabetic limbs were included. Results Twenty-five (50%) limbs with diabetic foot lesions reached the end of adequate healing or complete healing following revascularization (all had endovascular intervention). Twenty-one (42%) limbs had failed revascularization and had been amputated, and four (8%) patients died. After revascularization, the median APSV of the 25 limbs with healed or adequately healing lesions was signifi cantly higher than that of the 21 limbs with nonhealing lesions: 59.6 cm/s (30–90) versus 24.8 cm/s (10–60), P < 0.0001. At 37.5 cm/s as a cutoff value, it was found that the APSV showed a sensitivity of 90.5% (95% confi dence interval: 84.3–98.1%), a specifi city of 94.2% (95% confi dence interval: 77.3–96%), a positive predictive value of 90.5%, and a negative predictive value of 94.2% in predicting nonhealing lesions of diabetic foot.

Keywords

Ankle, diabetic patient, peak systolic velocity

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