Arterial reconstructions of the lower limbs in diabetics and nondiabetics. Comparative late results.
1,261 arterial reconstructions concerning the pelvis level and the lower limbs were performed in our department between 1970 and 1981. 510 of all patients (35.4%) were diabetics, a vascular reconstruction could be performed in 337 diabetic patients, in 173 an amputation was unavoidable. 62% of all diabetics underwent a bypass operation, 38% an aorto-iliac reconstruction. There were one and a half more females than in nondiabetics. The diabetics were operated five years later than nondiabetics. The numbers of risk factors was more frequent. The onset of vascular disorders was not dependent on duration or treatment of the diabetes. The clinical stage IV preponderated. Immediate limb salvage rate was 87.7% in our diabetics. The hospital mortality was 7.4%, in nondiabetics 3.8%. Comparative results between diabetics and nondiabetics concerning the five-, eight- and ten year patency and limb salvage rate for different graft materials were demonstrated. In diabetics the possibility of a deterioration after surgery is three times more frequent and the amputation rate is three times higher than in nondiabetics. The five year patency rate is 12% and the five year limb salvage rate 7% lesser in diabetics after femorotibial bypass.
D000368:Aged; D000671:Amputation, Surgical; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D003925:Diabetic Angiopathies / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014680:Veins / Q000637:transplantation