Background: Globally, over 170 million people have diagnosed DM, and by the year 2030, the prevalence is estimated to raise 2.5-fold. Diabetes mellitus (DM) is one of the strongest predictors of peripheral arterial occlusive disease and a significant risk factor for progression of asymptomatic disease or claudication into critical limb ischaemia (CLI). Critical limb ischaemia is the most advanced stage of peripheral arterial occlusive disease. The prognosis is poor, with amputation rates up to been 30% and mortality up to 25 % after 1 year.
Aim of the Work: The aim of this work is to evaluate the role of endovascular treatment of tibial artery occlusive disease in diabetic patients, as regard to efficacy, safety, as well as complications. Patients and Methods: This is prospective cohort study, diabetic patients with peripheral arterial occlusive disease (affecting tibial arteries), it is the study of 20 patients, Al-Azhar University Hospitals. Patients with Critical limb ischaemia (CLI) with Computerized Topographic Angiography (CTA) evidence of significant isolated tibial artery occlusive disease (anterior or posterior or both). Patients with generally adequate state of cardiac, respiratory and renal conditions that allow the procedure. Results: The present study was conducted on 20 diabetic patients, 11 males (55%) and 9 females (45%). Their age ranged between 50 years and 87 years with a mean age of 66.7 12.35. All 20 diabetic patients had tibial disease which ranges from segmental stenosis to total occlusion. The procedure time was estimated from the time of infiltration of local anaesthesia to the end of the procedure; It ranged from 45 min to 120 minutes with mean ± SD (88.920. min).The hospital stay ranged from 1 to 21 days with mean ± SD (5.5 ±6.8). Conclusion: Tibial angioplasty demonstrated its feasibility, safety and effectiveness in the treatment of diabetic patients with CLI. Limb salvage should be the main goal in patients with CLI due to infrapopliteal occlusive disease. With a prompt diagnosis, treatment can be started early and serious consequences may be avoided. Revascularisation that can prevent amputation is the ultimate treatment strategy.