Comparative analysis of patency, limb salvage and survival in diabetic and non-diabetic patients undergoing infrainguinal bypass surgery.
In 92 diabetic and 175 non-diabetic patients undergoing 336 femoropopliteal or femorodistal bypass procedures, 1- and 3-year cumulative life-table patency, limb salvage, and survival rates were comparatively analysed. The peroperative mortality rate was significantly higher in diabetic patients (5% compared to 1.4%, p < 0.001). The cumulative graft patency rates were 61% at 12 months and 46% at 36 months in diabetic patients compared to 64 and 52% in non-diabetic patients. Significantly better patency rates were observed in limbs with good runoff compared to limbs with poor runoff in both groups. The limb salvage rates at 3 years were 70% in diabetic patients and 62% in non-diabetic patients. The survival rate at 3 years was significantly lower in diabetic patients, 62% compared to 86% in non-diabetic patients. Diabetic patients with poor runoff demonstrated a significantly lower survival rate after 36 months compared to diabetic patients with good runoff (48% and 74%, respectively). The results of this study demonstrate that the early and intermediate patency and limb salvage rates are similar in diabetic and non-diabetic patients. On the other hand the survival rate in diabetic patients, especially in those with poor distal runoff, is significantly lower than non-diabetic patients.
Karacagil
S
S
Department of Surgery, University Hospital, Uppsala, Sweden.
Almgren
B
B
Bowald
S
S
Bergqvist
D
D
D000368:Aged; D001161:Arteriosclerosis / Q000401:mortality / Q000601:surgery*; D016022:Case-Control Studies; D003925:Diabetic Angiopathies / Q000401:mortality / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007264:Inguinal Canal / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency