IMPORTANCE OF ANGIOGRAPHY/ANGIOPLASTY IN DIABETIC FOOT
In my opinion, any investigation that does not alter the treatment plan, can be avoided in lower limb infections
Once color doppler confirms blockage of vessels, only if Vascular Bypass/Angioplasty is planned or anticipated, should the angiography be done.
Prognostically speaking, the color doppler has a higher prognostic value than the angiography in treatment of Diabetic Foot Infections. Similarly trans cutaneous oxygen measurement may give a better evaluation of possibility of the wound healing/leg salvage than the angiogram.
This is not to say that angiogram should be avoided, but my principle is to do it only when I intend to change the treatment plan to one of a peripheral vascular intervention like a vascular bypass or an angioplasty.