Background. Neuroischemic diabetic foot syndrome (NDFS) remains a major clinical and surgical challenge due to its high risk of limb loss and systemic complications. The coexist-ence of coronary artery disease (CAD) further complicates treatment strategies, often limiting surgical options and increasing perioperative risks. Endovascular interventions (EI) offer a mini-mally invasive alternative with potential for limb salvage and cardiovascular stability.

Aim. To evaluate the effectiveness and safety of endovascular revascularization in pa-tients with neuroischemic diabetic foot syndrome and concomitant coronary artery disease.

Materials and Methods. This single-center observational study included 114 patients with NDFS, 59 of whom had confirmed CAD. All patients underwent lower-limb endovascular interventions, including percutaneous transluminal angioplasty (PTA) with or without stenting. Outcomes assessed included technical success, limb salvage rate, amputation-free survival, cardi-ovascular complications, and 6-month mortality.

Results. Endovascular interventions were successful in 91.2% of cases. Patients with CAD had a higher incidence of periprocedural cardiovascular events (11.9% vs 3.6%, p<0.05), but no significant difference in limb salvage at 6 months (84.7% vs 86.4%). Amputation-free sur-vival was slightly lower in the CAD group but remained acceptable under strict perioperative cardiologic monitoring. The overall 6-month mortality was 5.2%, with no deaths directly attribut-ed to the endovascular procedures.

Conclusion. Endovascular interventions are effective in preserving limb viability in pa-tients with neuroischemic diabetic foot, even in the presence of coronary artery disease. Multidis-ciplinary assessment and perioperative risk stratification are essential to optimize outcomes.

Neuroischemic diabetic foot, coronary artery disease, endovascular intervention

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