[Diabetic gangrene in peripheral vascular occlusion. Saving the extremity by popliteo-pedal venous bypass]

23 patients with diabetic gangrene and complete occlusion of all 3 tibial arteries were treated by 26 popliteopedal vein bypass grafts. All 6 early graft failures resulted in major amputations. The cumulative graft patency rate was 76% after 6 years. One patient needed lower-leg amputation despite a functioning graft. All other limbs were saved (mean follow-up period: 24.8 months). It is concluded that despite a palpable popliteal pulse an angiographic examination should be performed, when the infectious lesion cannot be controlled by local treatment and pedal pulses are absent.