title: The diabetic patient has a higher benefit from infrapopliteal revascularization than the non-diabetic patient: a 10-year retrospective study.
abstract: OBJECTIVE
  The objective of this article is to evaluate the limb salvage and patency rates after crural arterial revascularization, differences between graft material and co-morbidities.
  
  
  METHODS
  All patients with crural artery bypasses were analysed retrospectively in a single centre (Department of Vascular Surgery, Thüringen Kliniken Saalfeld, Rudolstadt, Germany) over a 10-year period (1996-2006); 157 patients with 170 consecutive arterial reconstructions could be included.
  
  
  RESULTS
  Follow-up time was 55 months (6-119). Median age of the 56 women and the 101 men at the time of operation was 70 years (45.6-93.6). The five-year secondary patency rates were 71.5 ± 6.22% (vein), 44.3 ± 10.8% (composite; p = 0.0011), 52.6 ± 13.4% (prosthetic graft with distal vein cuff/patch; p = 0.00953) and 42 ± 12% (prosthetic graft without distal vein cuff/patch; p = 0.00443). Limb salvage rates after five years were 79.5 ± 5.8%, 61.6 ± 10.3%, 77.9 ± 11.3% and 70.1 ± 14.7%, respectively. Cumulative limb salvage rate was significantly higher in diabetic patients (78.9 ± 4.9%), than in non-diabetic patients (66.6 ± 6.8); p = 0.023.
  
  
  CONCLUSIONS
  Crural reconstruction is a suitable method for peripheral arterial occlusive disease to prevent amputation, particularly in diabetics.
authors.affiliation: Department of Vascular Surgery, University of Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany. alexander.oberhuber@med.uni-duesseldorf.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Oberhuber
authors.forename: Brigitte
authors.initials: B
authors.lastname: Benecke
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Orend
authors.forename: Siegfried
authors.initials: S
authors.lastname: Hutschenreiter
authors.forename: Bernd M
authors.initials: BM
authors.lastname: Muehling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003925:Diabetic Angiopathies / Q000601:surgery*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D023821:Limb Salvage / Q000379:methods*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000601:surgery*; D011150:Popliteal Artery / Q000637:transplantation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D016909:Tibial Arteries / Q000637:transplantation; D016896:Treatment Outcome; D014654:Vascular Patency