Foot angiography in diabetic patients with gangrene

The most unpleasant side effect of peripheral angiography is an intense pain and a burning sensation following the injection of the contrast material. It was recently shown (1) that the use of a non-ionic and less hypertonic contrast medium (metrizamide) in femoral angiography was associated with less pain when compared to an ionic medium (metrizoate). We thought it therefore advisable to perform foot angiography with such a non-ionic contrast medium (Amipaque, Nyegaard & Co, Oslo, Norway) in 9 diabetic patients with soft tissue and skeletal lesions of the foot. The angiographic examination was considered valuable for planning of therapy and predicting the prognosis. The results of the examinations are illustrated and discussed with regard to visualization of the digital arteries, subjective reactions to the angiographic examination and relationship of the vascular findings to soft tissue and skeletal lesions. It is stated that foot angiography performed with a non-ionic contrast medium is painless and allows contrast filling of the most peripheral digital arterial branches. On the basis of the angiographic findings the gangrenous lesions were categorized as ischemic or non-ischemic.