Abstract

The aim of this review was to compare different examinations and imaging methods to diagnose critical ischemia in the diabetic foot syndrome (DFS) excluding those methods used only to assess the microcirculation. Ankle or toe pressure measurements, oscillography, or transcutaneous oxygen measurements (TcPO₂) are regarded as tests of practical value.

In patients with ischemic foot ulcers and abnormalities of pulses or perfusion measurements, vascular imaging of the iliac, femoral, popliteal as well as the tibial vessels including the pedal arch is mandatory. Selective arteriography (DSA) is a recommended standard; however, there are noninvasive techniques (e.g., magnetic resonance angiography) that will be reliable with special advantages in cases of DSA with limitations or contraindications. As lower limb ischemia is a crucial determinant for the healing of diabetic foot ulcers, adequate assessment of the lower limb circulation should be performed.