Impact of diabetes mellitus on infrainguinal bypass grafting

The purpose of this study was to examine the role of diabetes mellitus (DM) in infrainguinal bypass graft outcome. One hundred forty-four patients who underwent 170 infrainguinal bypass grafts from 1990 to 1995 were reviewed retrospectively. Seventy-eight patients (94 bypasses) had DM and were followed for an average of 15.4 months; 13 patients were lost to follow up. The mean age was 68 years; 44 (56.4%) were men. The major indication for intervention was limb salvage for the DM (87/94, 92.6%) and non-DM (56/76, 73.7%) groups. No significant difference was found for perioperative wound complications, hematoma, myocardial infarction, or deep venous thrombosis between the DM and non-DM groups. Early mortalities were three for DM and one for non-DM patients. No significant difference was found between primary patency (p = 0.71), secondary patency (p = 0.32), limb salvage (p = 0.99), and survival (p = 0.72) between DM and non-DM groups. DM patients were more likely to have significant tissue loss (p = 0.009) and a longer hospital stay (p = 0.01). In conclusion, infrainguinal vein bypass grafting can be performed successfully in diabetic patients with comparable patency and limb-salvage rates to those without DM.