Durability of the tibial artery bypass in diabetic patients

Infrapopliteal bypass in diabetic patients has been associated with lower rates of patency and limb salvage than in nondiabetic patients. We prospectively compared the patency and limb salvage rates of in situ tibial artery bypass in diabetic and nondiabetic patients. Of 681 in situ bypasses performed for limb salvage over a 7 year period, 387 (57 percent) were carried out in diabetic patients and 294 (43 percent), in nondiabetic patients. Indications for operation most commonly included gangrene or ulceration (74 percent of the diabetic group and 49 percent of the nondiabetic group). Otherwise, the two patient groups were similar. Cumulative patency rates at 1 and 5 years were similar (91 and 74 percent for diabetic patients and 90 and 76 percent for nondiabetic patients, respectively). Limb salvage rates were also not significantly different (96 and 86 percent at 1 and 5 years, respectively, for diabetic patients and 99 and 94 percent, respectively for nondiabetic patients). Despite the unfavorable pattern of atherosclerosis in diabetic patients, the results of tibial arterial reconstructions showed patency and limb salvage rates similar to those seen in nondiabetic patients.