Neither procedure is superior.

The authors emphasized that thus far no scientific reason exists for preferring open surgery or endovascular infrapopliteal vascular interventions (1). According to the consensus of the International Working Group on the Diabetic Foot (2), neither procedure is superior to the other, since no randomized prospective comparative studies exist. The results seem comparable for both procedures and seem to depend on the distribution pattern of the peripheral arterial occlusive disease and the expertise at the vascular center. Vascular surgical patients with critical ischemia seem to have more complex occlusive patterns, and the treatment conditions become more difficult by prior endovascular treatments.