is angiography predictive?
Transmetatarsal amputation (TMA) is a durable reconstruction in the diabetic patient with limited forefoot gangrene. However, predicting TMA healing remains difficult. Our goals were to (1) determine the success rate of TMA and (2) identify factors predictive of TMA healing, in particular arterial foot anatomy. A retrospective review of all diabetic patients undergoing TMA was done. Blood supply to the foot was classified as mostly anterior (anterior tibial and/or dorsalis pedis artery), mostly posterior (posterior tibial or plantar arteries), or equally distributed (both systems patent or peroneal runoff). Foot vessels were assigned runoff scores from 0 to 3 according to Society for Vascular Surgery/International Society for Cardiovascular Surgery (SVS/ISCVS) criteria. Forty-four TMAs in 29 men and 12 women were reviewed. Revascularization was done in 35 cases. In nine cases (20%), no bypass was deemed necessary (n = 7) or feasible (n = 2). Blood flow to the foot was deemed mostly ant
