[Can distal vein arterialization be beneficial for the diabetic foot with necrosis?].
When arterial bypass cannot be used in cases of diabetic arteriopathy of the lower limbs, we have, since 1974, relied on the former method using the veins. Arterial blood is brought to the zone of ischaemia via an internal saphenous vein graft anastomosed distally to a vein in the foot, thus creating an arteriovenous fistula. Improvements in the technique include removing the valves in the dorsal venous arcade. Fourteen bypasses were performed in 13 diabetic patients with foot necrosis, including 12 with non-insulin dependent diabetes. There were 7 men and 6 women with a mean age of 83 years. The bypass was patent with a mean follow-up 15 months. At mean follow-up of 4 years (range 4 months-12 years), there were 9 successful operations and 5 failures. Two-thirds of the feet were saved more than 2 years including one more than 5 years and two more than 10 years. One patient died 4 days after the operation due to myocardial infarction. Heart failure was not observed in any of the patients. This technique can help preserve lower limbs otherwise compromised by insufficient arterial blood supply.
Lengua
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Générale et Vasculaire de l'Hôpital du Neuenberg, Ingwiller.
D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D017719:Diabetic Foot / Q000473:pathology / Q000601:surgery*; D005260:Female; D005528:Foot / Q000098:blood supply; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009336:Necrosis
Le pontage d'artérialisation veineuse distale peut-il être bénéfique au pied diabétique avec nécrose?