[Preliminary evaluation of clinical effects of below-knee arterial bypass on diabetic lower limb ischemia].
OBJECTIVE
To evaluate medium-long term patency of below-knee bypass on patients who suffered from diabetic lower limb ischemia.


METHODS
Clinical and follow-up data of 51 patients was retrospectively analyzed who underwent 56 below-knee bypass because of diabetes from November 2001 to December 2006. There were 35 male and 16 female with an average age of 68 years. They endured 26 months ischemic time lag in average, and had suffered from diabetes for 11 years. All of the patients were performed bypass to below-knee (posterior tibial, anterior tibial or peroneal) arteries. Kaplan-meier method was applied. The subgroups of different operative methods and different out-flow vessels were compared by Log-rank tests.


RESULTS
An average follow-up time of 23 months was achieved, and lost-follow-up rate was 15%. The total 1- and 5-year primary patent rates were 68% and 54% respectively, secondary patent rate were 70% and 60% respectively, limb salvage rates were 69% and 65%, survival rates were 82% and 60%. One year (3 years) of patent rate(s) of operative method subgroups of femoral-popliteal-infrageniculate bypass with composite grafts, femoral/popliteal-infrageniculate bypass with artificial grafts and femoral/popliteal-infrageniculate bypass with autologous veins were 70% (50%), 33% (33%) and 70% (70%) respectively. One year (4 years) of patent rate(s) of out-flow vessel subgroups of posterior tibial artery, anterior tibial artery and peroneal artery were 65% (60%), 80% (53%) and 77% (66%) respectively. However, both subgroups did not show any statistic differences by log-rank tests.


CONCLUSIONS
Partial or whole autologous veins as bypass grafts should be chosen when infrageniculate bypass is considered in diabetic patients. Considerable patent rates are acceptable no matter what kinds of out-flow vessels are chosen.
Wu
Ying-feng
YF
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Gu
Yong-quan
YQ
Li
Xue-feng
XF
Yu
Heng-xi
HX
Qi
Li-xing
LX
Guo
Lian-rui
LR
Cui
Shi-jun
SJ
Li
Jian-xin
JX
Zhang
Jian
J
Wang
Zhong-gao
ZG
D000368:Aged; D003925:Diabetic Angiopathies / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D016909:Tibial Arteries / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods