Surgical treatment of diabetic lower extremity ischemia using distal arterial bypass

Objective To investigate the effectiveness of surgical treatment for diabetic lower limb ischemia using distal arterial bypass. Methods From July 2000 to July 2004, ninety-six severe ischemic lower limbs in 82 diabetic patients were treated in Xuan Wu Hospital. Combined femoro-popliteal vascular prosthesis graft and tibial artery autologous graft were performed in 31 limbs (32.3%). Popliteal-tibial artery graft alone was performed in 22 limbs (22.9%). Combined iliac artery stenting, femoro-popliteal vascular prosthesis graft and tibial artery autologous graft were performed in 12 limbs (12.5%). Femoro-tibial artery graft was performed in 10 limbs (10.4%). Results 92 limbs of 79 patients were patent on discharge and 3 patients with 4 ischemic limbs (3.7%) died. Early operation success rate was 96.3%. The total effective rate was 93.7%. The limb salvage rate was 100% and foot ulcer healing rate was 37.3%. 96.2% patients were followed up, with a mean of 13.5 months. The total effective rate was 87.6%. The total amputation rate was 4.5%. The limb salvage rate was 95.9%. Mortality rate was 4.5%. The foot ulcer healing rate was 93.8% within 2-10 months with a mean of 6 months after discharge. Conclusions Diabetic foot is a serious complication of diabetes. Good result can be achieved using lower limb distal artery bypass. It can help avoid amputation or lower an amputation level.