Have Endovascular Advances Reinvented Limb Salvage Expectations?
In the early 1980s, LoGerfo opened the window of limb salvage in critical stages of diabetic atherosclerosis by fighting the misconception of microangiopathy that had previously prevented attempts to bypass arterial lesions in diabetic foot.1 He produced evidence that revascularization of distal diabetic arterial occlusions can be successful. This evidence in turn gave a fundamental push to expand and improve techniques of distal bypass.2,3 Physicians then applied the same techniques for the treatment of non-diabetic atherosclerosis to diabetic atherosclerosis. At this time, the concept of critical limb ischemia (CLI) emerged and limb salvage was the expected goal. Soon we saw that long-term results of distal revascularization in patients with diabetes were not inferior when physicians measured them in terms of limb salvage. This boosted the practice of distal bypass for diabetic arterial lesions. Subsequently, researchers observed that following distal bypass in patients with diabetes
