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Challenging the angiosome concept: Delineating peripheral arterial disease patterns in diabetic foot ulcers

Elham Sahebalzamani1, Pouya Tayebi2, Mahmoud Sadeghi Haddad Zavareh3

  • 1Medical Doctorate, Department of Vascular and Endovascular Surgery, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

Vascular
|May 10, 2024
PubMed

Insights

The angiosome concept offers insights into diabetic foot ulcer management, but this study found inconsistent correlations between below-the-knee artery involvement and ulcer locations. Collateral circulation is crucial for understanding ulcer severity.

Area of Science:

  • Vascular Surgery
  • Diabetic Foot Management
  • Angiology

Background:

  • The angiosome concept guides diabetic foot ulcer (DFU) management by linking vascular anatomy to wound healing.
  • Clinical application of the angiosome concept is debated due to complexities in foot vascularization and ulcer localization.

Purpose of the Study:

  • To evaluate the clinical validity of the angiosome concept in diabetic foot ulcer management.
  • To investigate the correlation between specific angiosomes and arterial supply patterns in patients with DFUs.

Main Methods:

  • A cross-sectional study involving 84 patients with DFUs undergoing lower limb angiography.
  • Analysis of demographic data, ulcer characteristics, and digital subtraction angiography findings.

Main Results:

  • Angiosome 2 showed the highest ulcer incidence (40.3%).
  • Posterior tibial artery (PTA) involvement was most common (72.9%), with 46.5% complete occlusion.
  • No significant correlation was found between angiosome categorization by supply patterns and specific arteries (p > .05).

Conclusions:

  • The angiosome concept provides limited, inconsistent support for correlating below-the-knee artery involvement with DFU locations.
  • Understanding DFU genesis and severity requires considering factors beyond angiosomal arterial supply, such as collateral circulation.

Keywords:
Peripheral arterial diseaseangiosome conceptcollateral circulationlower limb angiographyvascular supply

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