title: Revascularization of the ischemic diabetic foot by popliteal-to-distal bypass.
abstract: BACKGROUND
  Diabetic foot revascularization by popliteal-to-distal bypass is a procedure for limb salvage spread in the last decade.
  
  
  METHODS
  The authors report their experience with a consecutive series of 15 ischemic feet (mean transcutaneous oxygen 5.3 +/- 4.1 mmHg) with gangrenous lesions due to extensive tibial arteries occlusive disease beginning at the popliteal artery trifurcation (9 cases) or involving the distal popliteal artery (6 cases). Limb salvage was achieved by popliteal-to-distal bypass with autogenous inverted saphenous vein.
  
  
  RESULTS
  No operative death was observed. At a mean follow-up of 35 +/- 23 months (range 3-84 months) 4 bypasses were occluded and two were surgically revised after 4 and 50 months from surgery and subsequently remained patent. One patient was submitted to a major amputation. By life table analysis the cumulative primary and secondary patency and limb salvage rates for this group of diabetic patients were at 2 years 79.3%, 86.2% and 93.1% respectively (SE < 10%).
  
  
  CONCLUSIONS
  This small experience and a review of the literature confirm the validity of the popliteal-to-distal bypass and the need for a more aggressive vascular surgical attitude to treat the ischemic diabetic foot.
authors.affiliation: I Istituto di Clinica Chirurgica, Università degli Studi di Roma La Sapienza.
authors.forename: M
authors.initials: M
authors.lastname: Cavallini
authors.forename: S
authors.initials: S
authors.lastname: Caterino
authors.forename: G
authors.initials: G
authors.lastname: Murante
mesh_terms: D017719:Diabetic Foot / Q000601:surgery*; D005528:Foot / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D011150:Popliteal Artery / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods