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Diabetic neuropathy and Peripheral Arterial Disease (PAD) are the main etiological factors in foot ulceration. Herein, we report our experience of diabetic foot ulceration (DFU) management, with an analysis of the relationship between the rate of lower extremity amputation, in persons with infected DFU, after revascularization procedures performed to prevent major amputation. This study highlights the role of different biomarkers, showing their usefulness and potentiality in diabetic foot ulcer management, especially for the early diagnosis and therapy effectiveness monitoring. A retrospective analysis, from September 2016 to January 2021, of diabetic patients presenting diabetic foot with DFU, was performed. All patients were treated with at least one vascular procedure (endovascular, open, hybrid procedures) targeting PAD lesions. Outcomes measured were perioperative mortality and morbidity. Freedom from occlusion, primary and secondary patency, and amputation rate were registered. A total of 267 patients, with a mean age of 72.5 years, were included in the study. The major amputation rate was 6.2%, minor amputation rate was 17%. In our experience, extreme revascularization to obtain direct flow reduced the rate of amputations, with an increase in ulcer healing. [ABSTRACT FROM AUTHOR]

Aims: The study aims at the evaluation, of patients with chest pain and uninjured coronary arteries, and the impact of diabetes mellitus on coronary microcirculation. Moreover we want to verify whether a correlation between myocardial scintigraphy results and coronary angiography or not. Methods: The study population included 316 patients (173 males,143 females) with uninjured coronary arteries. Patients with chest pain (208) were divided into two populations: diabetics (72) and non-diabetics (136).We compared 66 patients with a myocardial scintigraphy with results of angiographic indexes. On angiographic images we evaluated, on the three major epicardial, Gibson's indexes (TFC, MBG), the Yusuf's index(TMBS) and a new index: Total Timi Frame Count (TTFC). Results: Patients with positive scintigraphy had a worse TMBS than patients with negative scintigraphy (p=0.003) and a lower TFC of healthy vessels than diseased vessels (p=0.0001). We found a worse coronary microcirculation in diabetic patients with lower values of MBG and TMBS (p=0.02),compared with non- diabetics. New index TTFC is usually higher in diabetics than non-diabetic patients. Conclusion: The study of microcirculation by coronary angiography and myocardial scintigraphy shows a good correlation between two methods. The analysis of diabetic patients and non-diabetic with chest pain and uninjured coronary arteries has led to assess that diabetic population has a major microcirculation disease. [ABSTRACT FROM AUTHOR]