Surgical treatment of lower limb ischemia in diabetic patients - long-term results
- PMID: 24482653
- PMCID: PMC3902717
- DOI: 10.5114/aoms.2013.39630
Surgical treatment of lower limb ischemia in diabetic patients - long-term results
Abstract
Introduction: Lower limb ischemia may cause nonhealing ulcers, infection, amputation and even mortality in diabetic patients. In this study, we review our data of ischemic lower limb revascularization procedures in diabetic patients and present the early, mid- and long-term results.
Material and methods: From March 2004 to September 2008, 83 patients with lower limb ischemia in Fontaine class III and IV underwent distal arterial bypass procedures. Saphenous vein grafts were used for below-knee arterial bypasses in all patients. In 16 (19%) patients femoropopliteal bypasses were performed with PTFE grafts. Short-term and long-term surgical results were evaluated.
Results: Ulcer recovery was determined in 36% of patients. Graft patency was 95% and 1 death (1%) occurred in short-term follow-up. In long-term follow-up the total effectiveness rate was 74%. Graft patency was 79% and 6 deaths (7%) occurred during the follow-up.
Conclusions: Lower limb ischemia is a serious event in patients with diabetes mellitus. The consequences may include increased mortality and morbidity in this particular patient population. However, distal arterial revascularizations are considerably effective procedures to avoid amputation, to eliminate symptoms, to promote ulcer recovery and to help the patient participate in social life with acceptable short, mid- and long-term follow-up results.
Keywords: diabetes mellitus; diabetic food; distal arterial bypass; ischemia.
References
-
- Hanna GP, Fujise K, Kjellgren O, et al. Intrapopliteal transcatheter interventions for limb salvage in diabetic patients: importance of aggressive interventional approach and role of transcutaneous oximetry. J Am Coll Cardiol. 1997;30:664–9. - PubMed
-
- Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53. - PubMed
-
- Bollinger A, Breddin K, Hess H, et al. Semi-quantitative assessment of lower limb atherosclerosis from routine angiographic images. Atherosclerosis. 1981;38:339–46. - PubMed
-
- Faglia E, Favales F, Quarantiello A, et al. Angiographic evaluation of peripheral arterial occlusive disease and its role as a prognostic determinant for major amputation in diabetic subjects with foot ulcers. Diabetes Care. 1998;21:625–30. - PubMed
-
- Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral arterial disease in diabetic and nondiabetic patients: a comparison of severity and outcome. Diabetes Care. 2001;24:1433–7. - PubMed
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