Objective. This study aimed to investigate the angiographic manifestations of lower extremity atherosclerotic steno-occlusive disease in patients with diabetes. Materials and Methods. A total of 162 patients with diabetes were enrolled in this study. The angiographic findings of lower extremity arterial lesions were evaluated according to location (iliac, femoral, popliteal, and crural artery), type (stenosis or occlusion), and length (<5？cm, 5–10？cm, and >5？cm). Results. A total of 131 of 162 (80.9%) diabetics showed multiple segmental lesions, and 19.1% (31/162) presented single segmental lesions in the lower extremity artery. Crural artery was the mainly involved location (39/162, 85.8%). Among the recorded 660 lesions of 162 cases, 437 (66.2%) were occlusion lesions, while 223 (33.8%) were stenosis lesions. Of 437 occlusion lesions, 308 lesions (70.5%) were in crural artery. More than 10？cm occlusion lesion (242/392, 61.7%) was the main manifestation in crural artery, especially in anterior (92/127, 67.2%) and posterior tibial arteries (91/124, 73.4%), which was higher than that in iliac artery (8/33, 24.2%), popliteal artery (53/157, 33.8%), and femoral artery (11/78, 14.1%). Conclusion. In diabetic subjects with lower limb artery ischemia, the vascular involvement is extremely diffuse and particularly severe in crural arteries, with high prevalence of more than 10 cm occlusion lesions. 1. Introduction The complications of diabetic vasculopathy commonly include two categories: microvascular and macrovascular complications. Macrovascular disease is the most common reason of mortality and morbidity in diabetes and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction, and peripheral vascular diseases (PAD) [1]. Epidemiological evidence has confirmed an association between diabetes and increased prevalence of PAD. The duration and severity of diabetes correlate with incidence and extent of PAD [2, 3]. Diabetes changes the nature of PAD. Traditionally, macrovascular diseases are thought as underlying obstructive atherosclerotic diseases of major arteries. Diabetic patients more commonly have infrapopliteal arterial occlusive disease and vascular calcification than nondiabetic cohorts [4]. Pathological changes of major blood vessels lead to functional and structural abnormalities in diabetic vessels including endothelial dysfunction, reduced vascular compliance, and atherosclerosis [5]. Diabetic lower extremity arterial disease is the main cause of nontraumatic amputation. Diabetic patients with lower extremity
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