[In situ bypass and diabetes].
From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p = 0.005). Critical limb-ischaemia was more often present in diabetic than non-diabetic patients (DM:57%, NDM:36%, p = 0.0002). Diabetic patients had a significantly lower distal anastomosis than non-diabetic patients (p = 0.00001). There were no differences among diabetic and non-diabetic patients regarding three years primary and secondary patency (58% and 64% respectively), and regarding major amputations. However, the rate of minor amputations was higher in insulin-dependent compared with non-insulin-dependent diabetics, who in turn had a higher rate than non-diabetics (p < 0.00001). A markedly decreased survival rate was found in diabetics (p < 0.00005). We found the in situ bypass technique very useful in the treatment of critical ischaemia of the lower limb in diabetic patients. The overall results in diabetic patients, whether insulin-dependent or not, were equal to those in non-diabetic patients.
Jensen
L P
LP
Rigshospitalet, karkirurgisk afdeling RK., København.
Schroeder
T V
TV
Lorentzen
J E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000401:mortality / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation*
In situ bypass og diabetes.