One-Year Evolution of Macrovascular and Microvascular Parameters After Endovascular Revascularization in Diabetic Foot Ulcers: A Prospective Multicenter Study.

Background: This study aimed to characterize the one-year longitudinal evolution of macrovascular and microvascular parameters following endovascular revascularization in patients with ischemic or neuroischemic diabetic foot ulcers (DFUs). Associations between early post-revascularization vascular parameters and wound-healing outcomes were evaluated as secondary exploratory analyses. Methods: A prospective multicenter longitudinal study included 27 ischemic or neuroischemic DFUs undergoing endovascular revascularization. Patients were followed for 12 months with serial assessments of ankle systolic pressure (AP), toe systolic pressure (TP), ankle-brachial pressure index (ABPI), toe-brachial pressure index (TBPI), transcutaneous oxygen pressure (TcPO2), and skin perfusion pressure (SPP). Secondary exploratory analyses evaluated associations between early vascular parameters and wound-healing outcomes. Results: Twenty-six ulcers (96.3%) achieved complete healing, with no major amputations or deaths during follow-up. AP, TP, ABPI, and TBPI improved significantly over 12 months (all p < 0.001), whereas TcPO2 showed a significant overall longitudinal effect (p = 0.010) despite greater variability, and SPP remained unchanged (p = 0.177). Exploratory secondary analyses suggested that higher AP at four weeks after revascularization was associated with shorter healing time (ρ = -0.451, p = 0.024), while higher TcPO2 values were observed in ulcers with early wound healing (p = 0.040). Conclusions: Macrovascular and microvascular parameters exhibit distinct recovery patterns following endovascular revascularization. Longitudinal assessment of both vascular compartments may provide complementary information for monitoring vascular recovery. The exploratory associations observed between early vascular parameters and wound-healing outcomes warrant confirmation in larger adequately powered studies.