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Published on: May 2, 2012
'Diabetic tibial disease': the case for revascularisation
B M Stephenson1, A A Shandall, K Shute
1Department of Surgery, Royal Gwent Hospital, Newport.
Annals of the Royal College of Surgeons of England
|March 1, 1993
Summary
Diabetic patients with critical limb ischemia can often avoid amputation. Short vein bypasses successfully revascularized limbs in a small study, preserving lower limb function and preventing major amputation.
Area of Science:
- Vascular Surgery
- Diabetic Limb Complications
Background:
- Diabetic patients with critical lower limb ischemia are often deemed unreconstructable.
- Palpable popliteal pulse in diabetics is frequently mislabeled as 'small vessel disease'.
Purpose of the Study:
- To evaluate the efficacy of short vein bypasses in limb salvage for diabetic patients with critical tibial disease.
- To emphasize the importance of thorough vascular assessment before amputation.
Main Methods:
- Retrospective analysis of nine diabetic patients (mean age 69) with critical limb ischemia.
- Utilized short vein bypasses for revascularization.
- Assessed patency rates and limb salvage outcomes.
Main Results:
- Major amputation was avoided in all nine patients.
- All revascularizations remained patent at a mean follow-up of 32 months (range 12-60 months).
Conclusions:
- Short vein bypasses are a viable option for limb salvage in select diabetic patients with critical tibial disease.
- Arteriography is crucial to assess distal revascularization potential before amputation.
- Doppler insonation of tibial and pedal vessels should be considered if arteriography is inconclusive.
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