Long-term outcome of infra-inguinal bypass for limb salvage: Are we giving diabetic patients a fair deal?
✍ Scribed by Sigurdsson, HH ;MacAulay, EM ;Cooper, GG ;McHardy, KC
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 322 KB
- Volume
- 16
- Category
- Article
- ISSN
- 1357-8170
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✦ Synopsis
Abstract
We have reviewed the long‐term outcome of one surgeon's practice of surgery for lower limb ischaemia in diabetic and non‐diabetic patients, with a minimum follow‐up period of three years. Of 56 critically ischaemic lower limbs in 52 diabetic patients, 43 were managed by infra‐inguinal bypass and 13 by amputation. A similar pattern of management was observed in a control group of 126 non‐diabetic patients who underwent infra‐inguinal bypass (96 limbs) or primary amputation (40 limbs). In the infra‐inguinal bypass group, actuarial survival at three years was 49% for those with diabetes and 55% for those without. Actuarial amputation‐free survival atthree years was42% for diabetic patients and 50% for others. Although there appears to be a trend for diabetic patients to perform less well, there was no statistically significant difference in these outcome measures (survival—Chi) Square 3.1693, p=0.075; amputation‐free survival—Chi Square 2.627, p=0.105. We conclude that groups of diabetic patients, like non‐diabetic patients, can expect substantial benefit from infra‐inguinal bypass.