title: Impact of diabetes mellitus on infrainguinal bypass grafting.
abstract: The purpose of this study was to examine the role of diabetes mellitus (DM) in infrainguinal bypass graft outcome. One hundred forty-four patients who underwent 170 infrainguinal bypass grafts from 1990 to 1995 were reviewed retrospectively. Seventy-eight patients (94 bypasses) had DM and were followed for an average of 15.4 months; 13 patients were lost to follow up. The mean age was 68 years; 44 (56.4%) were men. The major indication for intervention was limb salvage for the DM (87/94, 92.6%) and non-DM (56/76, 73.7%) groups. No significant difference was found for perioperative wound complications, hematoma, myocardial infarction, or deep venous thrombosis between the DM and non-DM groups. Early mortalities were three for DM and one for non-DM patients. No significant difference was found between primary patency (p = 0.71), secondary patency (p = 0.32), limb salvage (p = 0.99), and survival (p = 0.72) between DM and non-DM groups. DM patients were more likely to have significant tissue loss (p = 0.009) and a longer hospital stay (p = 0.01). In conclusion, infrainguinal vein bypass grafting can be performed successfully in diabetic patients with comparable patency and limb-salvage rates to those without DM.
authors.affiliation: Department of Surgery, Allegheny University Hospitals/Allegheny University of the Health Sciences, Philadelphia, Pennsylvania, USA.
authors.forename: V
authors.initials: V
authors.lastname: Gahtan
authors.forename: M
authors.initials: M
authors.lastname: Harpavat
authors.forename: A B
authors.initials: AB
authors.lastname: Roberts
authors.forename: M D
authors.initials: MD
authors.lastname: Kerstein
mesh_terms: D000368:Aged; D001162:Arteriosclerosis Obliterans / Q000209:etiology / Q000601:surgery; D001166:Arteriovenous Shunt, Surgical; D003925:Diabetic Angiopathies / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014654:Vascular Patency