OBJECTIVE: The purpose of this study was the examination of the effect of successful large vessel revascularization on the microcirculation of the @entity6 . RESEARCH DESIGN AND METHODS: We measured the cutaneous microvascular reactivity in the foot in 13 @entity1 with @entity6 with peripheral @entity455 and @entity16 (group DI) before and 4 to 6 weeks after successful lower extremity arterial revascularization. We also compared them with age-matched and sex-matched groups of 15 @entity1 with @entity6 and @entity16 , seven @entity1 without @entity16 , and 12 healthy @entity1 for control. We used single-point and laser Doppler scan imaging for the measurement of the foot skin vasodilatation in response to heating to 44 degrees C and to iontophoresis of 1% @entity934 (endothelial-dependent response) and 1% @entity1854 (endothelial-independent response). RESULTS: The group DI response to heat increased from 289% +/- 90% before surgery (percent increase over baseline measured in volts) to 427% +/- 61% (P <.05) after surgery but was still comparable with the response of the @entity1 with @entity6 and @entity16 (318% +/- 51%) and lower than the responses of the @entity1 without @entity16 (766% +/- 220%) and the healthy @entity1 for control (891% +/- 121%; P <.0001). The group DI @entity934 response also improved from 6% +/- 4% before surgery to 26% +/- 8% after surgery (P <.05) and was similar to the responses of @entity1 with @entity6 and @entity16 (18% +/- 3%) and @entity1 without @entity16 (38% +/- 8%) but still lower when compared with the response of the @entity1 for control (48% +/- 9%; P <.001). The @entity1854 response for group DI improved from 10% +/- 4% to 29% +/- 9% (P <.05) and was similar to the responses of the neuropathic (25% +/- 9%), nonneuropathic (32% plus minus 6%), and control (40% +/- 5%) groups. The group DI neurovascular response, which depends on the healthy function of the @entity7183 nociceptors, was similar at baseline (5% +/- 9%) and after surgery (14% +/- %10) and in the neuropathic group (33% +/- 21%), but it was dramatically reduced when compared with the nonneuropathic (110% +/- 40%) and control (198% +/- 54%) groups (P <.001). CONCLUSION: Impaired vasodilation in the @entity6 neuropathic lower extremity leads to functional @entity63 , which improves considerably but is not completely corrected with successful bypass grafting surgery. Therefore, @entity1 with @entity6 and @entity16 may still be at high risk for the development of foot ulceration or the failure to have an existing @entity1066 heal despite adequate correction of large vessel blood flow.

Cutaneous microcirculation in the neuropathic XXXX foot improves significantly but not completely after successful lower extremity revascularization.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity455 :: ('MESH:D014652', 'Disease') :: ['arterial disease'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic', 'diabetes', 'neuroischemic diabetic foot'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neuropathy'] @entity1854 :: ('MESH:D009599', 'Chemical') :: ['sodium nitroprusside'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer'] @entity7183 :: ('10185', 'Species') :: ['C-fiber'] @entity934 :: ('MESH:D000109', 'Chemical') :: ['acetylcholine']
@entity6 :: (MESH:D003920,Disease) :: ['diabetic']
