Clinical efficacy of endovascular revascularization combined with vacuum-assisted closure for the treatment of diabetic foot

Figure 1 Surgery pictures of infrapopliteal artery occlusion case. A: Lower extremity computerized tomography angiography suggests infrapopliteal artery occlusion; B: Gangrene of the fourth toe with infection; C-E: Long-segment occlusions of the anterior tibial artery, posterior tibial artery and peroneal artery; distal dorsal pedis artery and posterior tibial artery were demonstrated through lateral branches; F and G: The anterior tibial artery and peroneal artery were dilated by balloon angioplasty (BA) during the operation; H-J: After BA, the anterior tibial artery and peroneal artery were unobstructed, and the communication between lateral plantar artery and peroneal artery was developed; K and L: After revascularization, local debridement, removal of necrotic tissue and the 3^rd and 4^th phalanx, and vacuum-assisted closure (VAC) aspiration were performed; M: The wound surface two weeks after VAC; N: The wound granulation tissue grew well three weeks after VAC and reached the conditions for skin grafting; O: Skin grafting with split-thickness skin graft from the inner leg; P: Wound repair two months after skin grafting.