Electroacupuncture at Taixi (KI3) and Sanyinjiao (SP6) Alleviates Re-Ischemic Injury after Endovascular Intervention in Patients with Diabetic Foot: A Randomized Controlled Trial

Objective: To evaluate the efficacy and potential mechanisms of electroacupuncture (EA) at Taixi (KI3) and Sanyinjiao (SP6) in preventing re-ischemic injury following percutaneous transluminal angioplasty (PTA) in patients with diabetic foot (DF). Methods: A randomized controlled trial was conducted between January 2023 and December 2025. A total of 180 DF patients who underwent successful PTA were randomly assigned to three groups (n = 60 each): conventional therapy group (CT), sham acupuncture group (SA), and electroacupuncture group (EA). All patients received standard pharmacological therapy postoperatively. The EA group received EA at KI3 and SP6 on the affected limb (disperse wave, 15 Hz, 30 min/day for 7 consecutive days); the SA group received superficial needling at non-acupoint sites (≈2 cm lateral to target points); the CT group received conventional therapy alone. Primary outcomes included incidence of re-ischemia within 7 days post-PTA. Secondary outcomes comprised ankle-brachial index (ABI), mean blood flow velocity in the dorsalis pedis artery (Vm), numerical rating scale (NRS) for pain, and activated partial thromboplastin time (APTT). Results: ABI, Vm, and NRS scores significantly improved postoperatively in all groups (P < 0.001), but no intergroup differences were observed (P > 0.05). The re-ischemia incidence was 1.67% (1/60) in the EA group, significantly lower than 13.33% (8/60) in the CT group (P = 0.008) and 11.67% (7/60) in the SA group (P = 0.015). Postoperatively, the activated partial thromboplastin time (APTT) in the EA group was 32.00 (29.00, 35.00) s, which was significantly longer than that in the CT group (P < 0.05), whereas platelet counts decreased similarly across groups (P = 0.970). Conclusion: Adjunctive EA at KI3 and SP6 significantly reduces the risk of re-ischemia after PTA in DF patients, potentially via modulation of coagulation function—specifically, prolongation of APTT to suppress thrombus formation—without compromising metabolic control or increasing bleeding risk. This strategy offers a safe, feasible, and cost-effective complementary approach for post-interventional vascular protection.