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[Pedal bypass in the treatment of ischemic diabetic foot]
P Tosenovský1, B Zálesák, M Adamec
1Klinika transplantacní chirurgie IKEM, Praha.
Insights
Pedal bypass surgery offers a safe and effective solution for limb salvage in diabetic patients with critical limb ischemia. This procedure demonstrates acceptable graft patency and limb salvage rates in the medium term.
Area of Science:
- Vascular Surgery
- Diabetic Foot Complications
- Reconstructive Microsurgery
Context:
- Diabetic ischemic feet present a significant challenge in limb salvage.
- Critically ischemic diabetic feet often require advanced surgical interventions.
Purpose:
- To assess the graft patency and limb salvage rates following pedal bypass surgery in diabetic patients with critical limb ischemia.
- To evaluate the safety and efficacy of pedal bypass for limb salvage in this patient population.
Summary:
- A retrospective analysis of 41 pedal bypass surgeries in 50 critically ischemic diabetic feet was conducted.
- The study reported a 61% graft patency and 76% limb salvage rate at a median follow-up of 16.7 months.
- All successfully revascularized feet healed within 3 months, with no 30-day postoperative mortality.
Impact:
- Pedal bypass surgery is a viable option for limb salvage in diabetic ischemic feet.
- This technique allows for expanded indications for limb salvage, improving patient outcomes.
- The findings support the use of pedal bypass to prevent amputation in complex diabetic foot cases.
Aim:
The aim of this retrospective analysis was assessment of both patency and limb salvage rates of diabetic ischemic feet which underwent pedal bypass surgery within the period of 3 years.
Material And Methods:
Authors evaluated 50 critically ischemic diabetic feet where the pedal bypass was indicated for limb salvage. Total 41 pedal bypasses were performed and median follow-up was 16.7 months (1-39). The free muscle transfer were performed either in one session with or subsequently after the pedal bypass surgery in six limbs.
Results:
Authors achieved 61% and 76% graft patency and limb salvage rates, respectively, within the median 16.7 months follow-up. All successfully revascularised feet healed up within the median period of 3 months postoperatively. No patient died within 30 days postoperatively.
Conclusion:
We conclude, that pedal bypass is safe procedure with acceptable limb salvage rate in the medium-term follow-up. Surgeons can markedly extend an indication criterions for limb salvage by exploiting of this technique.