[Surgical treatment of peripheral arterial occlusive disease in diabetes mellitus; in situ saphenous vein bypass versus reverse bypass procedure--a retrospective study].
The scope of reconstructive possibilities in the treatment of patients with peripheral occlusive arterial disease and diabetes mellitus had been increased thanks to further development of surgical methods. It is especially the in-situ-bypass procedure which has opened the path to new anastomotic sites at the level of the foot. Our own experience with 86 bypass procedures in 84 patients has given us an early patency rate of 82% in non-diabetic arterial occlusions and of 80% in diabetics. The amputation rate was 7% in the former group, 14% in diabetics with atherosclerotic occlusion. In comparison to the reversed bypass the early graft occlusion rate fell from 26% to 14% and the amputation rate from 13 to 9%. Thus, operative mortality fell from 9 to 2.4%, although the average age had risen from 61 to 67 years and the percentage of stage IV disease from 38% to 51%. Patency of bypass procedures with anastomosis to distal calf arteries was 83% und rose to 92% if the distal anastomosis was to arteries in the vicinity of the ankle. The caveat in this study is the fact that an apparent superiority of the in-situ-bypass is based on retrospective comparison of somewhat widely separated historical groups.
Sandmann
W
W
Abteilung für Gefässchirurgie und Nierentransplantation, Universität Düsseldorf.
Kniemeyer
H W
HW
Jalschak
R
R
Grabitz
K
K
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001158:Arteries / Q000601:surgery; D003925:Diabetic Angiopathies / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*
Operative Behandlung der peripheren arteriellen Verschlusserkrankung bei Diabetes mellitus; in-situ-Saphena-Bypass versus Umkehrbypassverfahren--eine retrospektive Studie.