Because most patients with these ulcers have little or no macrovascular occlusive disease, debridement, trimming of the callus, and antibiotics frequently produce good healing. Drainage of the infection may prevent major surgery. After the ulcer has healed, appropriate inserts or special shoes should be prescribed. These treatments may be performed by interventional radiologists, vascular surgeons, or cardiologists. However, because of the high recurrence rate of obstruction, alternative methods may be necessary.
Stents are very strong and keep the vessel open much better than balloons alone.
Moreover, the recurrence rate is reportedly less. They work less well in smaller arteries or when the occlusion is long. Stents for carotid disease are being studied. PTA is useful for the treatment of localized occlusive arterial lesions due to atherosclerosis. Successful PTA avoids the need for surgery and requires only 1 or 2 days of hospitalization.