Surgical treatment of lower limb ischemia in diabetic patients - long-term results.
BACKGROUND
Lower limb ischemia may cause nonhealing ulcers, infection, amputation and even mortality in diabetic patients. In this study, we review our data of ischemic lower limb revascularization procedures in diabetic patients and present the early, mid- and long-term results.


METHODS
From March 2004 to September 2008, 83 patients with lower limb ischemia in Fontaine class III and IV underwent distal arterial bypass procedures. Saphenous vein grafts were used for below-knee arterial bypasses in all patients. In 16 (19%) patients femoropopliteal bypasses were performed with PTFE grafts. Short-term and long-term surgical results were evaluated.


RESULTS
Ulcer recovery was determined in 36% of patients. Graft patency was 95% and 1 death (1%) occurred in short-term follow-up. In long-term follow-up the total effectiveness rate was 74%. Graft patency was 79% and 6 deaths (7%) occurred during the follow-up.


CONCLUSIONS
Lower limb ischemia is a serious event in patients with diabetes mellitus. The consequences may include increased mortality and morbidity in this particular patient population. However, distal arterial revascularizations are considerably effective procedures to avoid amputation, to eliminate symptoms, to promote ulcer recovery and to help the patient participate in social life with acceptable short, mid- and long-term follow-up results.
Cardiovascular Surgery Department, Bezmi Alem University, Istanbul, Turkey.
Bekir
B
Inan
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Unal
U
Aydin
Anadolu Medical Center Hospital, Cardiovascular Surgery Clinic, Istanbul, Turkey.
Murat
M
Ugurlucan
Cardiovascular Surgery Department, Bezmi Alem University, Istanbul, Turkey.
Cemalettin
C
Aydin
Cardiovascular Surgery Department, Bezmi Alem University, Istanbul, Turkey.
Melike Elif
ME
Teker
diabetes mellitus; diabetic food; distal arterial bypass; ischemia