[Results of sub-inguinal revascularization in the treatment of diabetic ischemic foot].
From January 1993 to August 1995, we performed 60 revascularizations of the lower limb using 65 bypasses in 55 patients (32 men, 23 women, mean age 66.6 yars) with diabetes. Trophic lesions of the foot existed in 57 of the revascularizations, and in 3 cases pain was provoked by the supine position. Supra-articular femoropopliteal bypass was performed in 8 cases, subarticular femoropopliteal bypasses in 25, femorotibial bypasses in 14 and paramalleolar bypasses in 18. There were 6 post-operative deaths. Six major amputations were required including 2 despite patent bypasses. Twenty-nine minor amputations were required for trophic disorders. There were 5 deaths after the postoperative period in which 4 major amputations were required despite patent bypasses in 2 cases. Retarded cicatrization was seen in 13 of the amputation stumps of areas of atrophism. Actuarial survival at 2 years was 77 +/- 6% with primary patency of 53 +/- 9.5% and secondary patency of 74 +/- 7%. The rate of success in saving the lower limb was 80.5 +/- 5.6%. Bypass revascularization has been effective in the treatment of the diabetic ischemic foot. Operative mortality was high, resulting from associated cerebral vascular events and coronary heart disease.
Chambon
J P
JP
Clinique chirurgicale adultes Ouest, hôpital Claude-Huriez, Lille.
Fontaine
P
P
Vambergue
A
A
Fournier
A
A
Fossati
P
P
Quandalle
P
P
D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000401:mortality; D017719:Diabetic Foot / Q000601:surgery*; D005260:Female; D006801:Humans; D007264:Inguinal Canal / Q000098:blood supply; D007866:Leg / Q000098:blood supply*; D008297:Male; D012307:Risk Factors; D013997:Time Factors
Résultats des revascularisations sous-inguinales dans le traitement des pieds diabétiques ischémiques.