[Surgical treatment in patients with diabetic macroangiopathy]

Diabetes mellitus is a disease distributed on a worldwide scale. Although the therapeutic approach to diabetes mellitus and its complications in current use brings about considerable prolongation of the life expectancy in diabetics, the frequency of cardiovascular complications is constantly augmenting; the latter are taken to be the underlying cause of death in this contingent of patients. The lower extremities are usually affected by chronic arterial insufficiency. The aim of this study is to analyze the results of surgical treatment of the occlusive arterial lesions in the lower extremities of diabetics, and specify the indications and type of intervention. Over a 6-year period (1987-1992), 760 arterial operations of the lower extremities are performed. Ninety-six reconstructions are done in diabetics-12.15 per cent. The youngest patient is 39 years of age, and the eldest--80 years. 75 per cent of the patients are given treatment with oral antidiabetic drugs. Most of them have concomitant diseases--72 cases (75 per cent). Seventy-one (73.96 per cent) present clinical manifestation of rest pain and/or ulcerations, and only 25 cases (26.4 per cent)--intermittent claudication according to R. Fontain. Those with arterial lesions in both segments prevailed--aorto- or iliofemoral lesion. Doppler sonography is performed in all patients with the exception of two studied by angiography. The operative procedures performed include: femoropopliteal--35, aorto-bifemoral--33, aorto- or ilio-femoral bypass-9, arterial reconstructions in both segments--14. The postoperative results are good and fair in 85 cases (88.5 per cent).(ABSTRACT TRUNCATED AT 250 WORDS)