[Long-term results after infrainguinal arterial reconstruction in patients with type 2 diabetes mellitus and without diabetes mellitus].
The influence of type II diabetes on the success rate of arterial bypass operations in the leg was assessed in a prospective study, since 1984, of long-term results of infrainguinal arterial reconstruction in 67 type II diabetics (41 men and 26 women; mean age 71.2 [47-90] years) and compared with 133 nondiabetics (90 men and 43 women; mean age 71.5 [45-91] years). All had a bypass for chronic critical ischaemia of the legs. Graft patency, leg preservation and survival rate were calculated and compared by the actuarial method. Coronary heart diseases and cerebral ischaemia were a little more common in the diabetic group, but the incidence of heart failure was the same (20%). A venous bypass was used in 73% of diabetics, polytetrafluoroethylene grafts in 27% (nondiabetics: 79% and 21%). Bypass occlusions occurred in 9 diabetics and in 24 nondiabetics (not significant). During the observation period of 5 years 37 diabetics (55%) and 39 nondiabetics (29%) died (P less than 0.001). These data indicate that the results of infrainguinal arterial bypass operations are equally good in diabetics and nondiabetics. Amputation was avoided in 80% of legs at risk in both groups. Primary amputation is indicated only in exceptional circumstances.
Stirnemann
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P
Universitätsklinik für Thorax-, Herz- und Gefässchirurgie, Inselspital Bern.
Würsten
H U
HU
Krebs
T
T
D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors; D014680:Veins / Q000637:transplantation*
D011138:Polytetrafluoroethylene
Langzeitergebnisse nach infrainguinaler Arterienrekonstruktion bei Typ-II-Diabetikern und Nicht-Diabetikern.