title: [Surgical vascular by-pass operation of lower limb artery occlusion in patients with diabetic foot].
abstract: OBJECTIVE
  To document the effectiveness and patient experience of surgical treatment for diabetic lower limb arterial occlusion.
  
  
  METHODS
  Out of 290 diabetic patients with lower limb arterial occlusion, 69 received by-pass operation because of severe stenosis below the abdominal aorta and severe ulcers in feet from April 2004 to April 2011. We reviewed the experience and outcome of the 69 diabetic patients who underwent surgical operations on lower limb arterial occlusion.
  
  
  RESULTS
  100% initial surgical success was achieved. The morbidity (excluding death) was 12.3% +/- 4.1% and 15.7% +/- 5.1% at 1 year and 3 years after operations, respectively. Five (7.2%) death cases were recorded, which resulted in a survival rate of 94.2% +/- 2.8% and 92.0% +/- 3.5% at 1 year and 3 years after operations, respectively. About 90.6% +/- 3.6% and 87.2% +/- 4.9% of patients had graft patency 1 year and 3 years after operations, respectively; and 6. 5% + 3. 1% had amputations. Four (5. 8%) patients developed graft thrombosis, in which 2 (2.9%) had amputations because of recurrence of thrombosis after thrombectomy. Two (2.9%) patients had amputations because of graft infection accompanied with graft resection operations. One (1.4%) patient received repeated arterialized operation on great saphenous vein because of popliteal artery occlusion, and obtained a good outcome within two years. One (1.4%) patient developed stomas false aneurysm, but the excision of the false aneurysm resulted in a good outcome in four years.
  
  
  CONCLUSIONS
  Detailed pre-operation assessment, optimal selection of surgical procedure and perioperative management can help improve the outcome of diabetes and decrease amputation rate in patients with diabetic lower limb arterial occlusion.
authors.affiliation: Department of the Vascular Surgery and Endovascular Center, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.forename: Ji-Chun
authors.initials: JC
authors.lastname: Zhao
authors.forename: Yu-Kui
authors.initials: YK
authors.lastname: Ma
authors.forename: Xing-Wu
authors.initials: XW
authors.lastname: Ran
authors.forename: Ding
authors.initials: D
authors.lastname: Yuan
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.forename: Zhou-Peng
authors.initials: ZP
authors.lastname: Wu
authors.forename: Wu-Sheng
authors.initials: WS
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D017719:Diabetic Foot / Q000601:surgery*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*