Ten to 25 % of all diabetic patients will develop a lower limb ulcer in their lifetime. Ankle-brachial index is not accurate in diabetic patients .The resting systolic toe pressure (TP) may be a measure of small arterial function within the periphery.

Objective: The purpose of this article is to consider the effect of below-knee angioplasty on systolic toe pressure changes in diabetic patients with critical limb ischemia.

Methods/Materials: In this prospective study 114 patients, were included who satisfied the inclusion criteria: patients with critical limb ischemia in the form of tissue loss(ulcer or gangrene) or rest pain, presence of below-knee vessel lesion, and absence of proximal vessels lesion or stenosis. We evaluated the effect of angioplasty on toe pressure of diabetic patients and compared them to non-diabetics.

Results: Among 114 patients, 78(68/4%) were men and 36(31/6%) were women. Diabetic patients were 96(84/2%) and non-diabetics were 18 (15.8%). In Paired T-Test analysis we compared toe pressure values of each patient before and after angioplasty and it was a significant difference in both Diabetic and non-diabetic groups.(0.00 and 0.008 respectively). The mean of systolic toe pressure before angioplasty had no difference between the 2 groups (PValue: 0.13). The mean of toe pressure in non-diabetic patients was 42±31.9 and in diabetics was 25.6 and after angioplasty, the mean of toe pressure raised 44.3 in non-diabetics and 19.4 in diabetics.

Conclusions: Systolic toe pressure is a valuable tool to evaluate and predict angioplasty effect on below-knee ulcers especially in diabetic patients.

Keywords: Below knee Angioplasty, Systolic toe pressure, Diabetes