Arterial reconstruction extending below the popliteal bifurcation.

Area of Science:

• Vascular Surgery
• Diabetic Complications
• Peripheral Artery Disease

Background:

• Severe distal ischemia significantly threatens limb viability.
• Arterial repair below the popliteal artery is a critical intervention for limb salvage.
• The impact of diabetes mellitus on outcomes of such procedures requires evaluation.

Purpose of the Study:

• To evaluate the outcomes of arterial anastomoses below the popliteal artery in patients with severe distal ischemia.
• To assess the influence of diabetes mellitus on the success and complications of these vascular repairs.
• To determine the limb salvage rate and long-term patency in this patient cohort.

Main Methods:

• Retrospective analysis of 172 arterial anastomoses performed below the popliteal artery.
• Inclusion of patients primarily suffering from severe distal limb ischemia.
• Data collection on in-hospital mortality, patency rates, and major amputation rates, with subgroup analysis for diabetic patients.

Main Results:

• An in-hospital mortality rate of 7.6% was observed.
• Patency rates were 83% on discharge and 39% at 3 years among survivors.
• Major amputation rates were 37/172 overall and 15/47 in diabetic patients, indicating considerable limb salvage.

Conclusions:

• Arterial repair below the popliteal artery provides a substantial limb salvage rate for patients with severe distal ischemia.
• Diabetes mellitus does not appear to adversely affect the outcomes of these procedures.
• Patients with diabetes and severe distal ischemia should be considered candidates for arterial reconstruction.