Abstract
Peripheral arterial disease is a fundamental consideration in the patient presenting with a diabetic foot. Although broad in context, it is only part of the overall alteration in vascular structure and function characterized by two distinct pathologic processes: a nonocclusive microcirculatory impairment involving the capillaries and arterioles of the kidneys, retina, and peripheral nerves and a macroangiopathy manifesting as atherosclerotic lesions of the coronary and peripheral arterial circulation. The former is relatively unique to diabetes and is best described as an accelerated microangiopathy rather than an occlusive process. In addition to its well-recognized contribution to the development of diabetic neuropathy, retinopathy, and nephropathy, this microvascular dysfunction is also of paramount importance in the diabetic foot.
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References
Akbari CM, LoGerfo FW. Diabetes and peripheral vascular disease. J Vasc Surg. 1999;30:373–84.
LoGerfo FW, Coffman JD. Vascular and microvascular disease of the foot in diabetes. N Engl J Med. 1984;311:1615–9.
Parkhouse N, LeQueen PM. Impaired neurogenic vascular response in patients with diabetes and neuropathic foot lesions. N Engl J Med. 1988;318:1306–9.
Akbari CM, LoGerfo FW. Peripheral vascular disease in the person with diabetes. In: Porte D, Sherwin RS, Baron AD, editors. Ellenberg and Rifkin’s diabetes mellitus. 6th ed. New York: McGraw-Hill; 2003. p. 845–57.
Flynn MD, Tooke JE. Aetiology of diabetic foot ulceration: a role for the microcirculation? Diabet Med. 1992;8:320–9.
Akbari CM, LoGerfo FW. The micro- and macrocirculation in diabetes mellitus. In: Veves A, editor. A clinical approach to diabetic neuropathy. 1st ed. New York: Humana; 1998. p. 319–31.
Veves A, Akbari CM, Primavera J, et al. Endothelial dysfunction and the expression of endothelial nitric oxide synthetase in diabetic neuropathy, vascular disease, and foot ulceration. Diabetes. 1997;47:457–63.
Ruderman NB, Haudenschild C. Diabetes as an atherogenic factor. Prog Cardiovasc Dis. 1984;26:373–412.
Brand FN, Abbott RD, Kannel WB. Diabetes, intermittent claudication, and risk of cardiovascular events. The Framingham Study. Diabetes. 1989;38:504–9.
Stokes J, Kannel WB, Wolf PA, Cupples LA, D’Agostino RB. The relative importance of selected risk factors for various manifestations of cardiovascular disease among men and women from 35 to 64 years old: 30 years of follow-up in the Framingham Study. Circulation. 1987;75:65–73.
Tuomilehto J, Rastenyte D, Jousilahti P, Sarti C, Vartiainen E. Diabetes mellitus as a risk factor for death from stroke: prospective study of the middle-aged Finnish population. Stroke. 1996;27:210–5.
Dormandy J, Heeck L, Vig S. Predicting which patients will develop chronic critical leg ischemia. Semin Vasc Surg. 1999;12:138–41.
Menzoian JO, LaMorte WW, Paniszyn CC, et al. Symptomatology and anatomic patterns of peripheral vascular disease: differing impact of smoking and diabetes. Ann Vasc Surg. 1989;3:224–8.
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Akbari, C.M. (2012). Clinical Features and Diagnosis of Peripheral Arterial Disease. In: Veves, A., Giurini, J., LoGerfo, F. (eds) The Diabetic Foot. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-791-0_5
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DOI: https://doi.org/10.1007/978-1-61779-791-0_5
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