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A Journal on Heart and Vascular Diseases

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 1999 January-February;47(1-2):7-14

language: English, Italian

Revascularization of the ischemic diabetic foot by popliteal-to-distal bypass

Cavallini M., Caterino S., Murante G.


Background. Diabetic foot revascularization by popliteal-to-distal bypass is a procedure for limb salvage spread in the last decade.
Methods. The authors report their experience with a consecutive series of 15 ischemic feet (mean transcutaneous oxygen 5.3±4.1 mmHg) with gangrenous lesions due to extensive tibial arteries occlusive disease begining at the popliteal artery trifurcation (9 cases) or involving the distal popliteal artery (6 cases). Limb salvage was achieved by popliteal-to-distal bypass with autogenous inverted saphenous vein.
Results. No operative death was observed. At a mean follow-up of 35±23 months (range 3-84 months) 4 bypasses were occluded and two were surgically revised after 4 and 50 months from surgery and subsequently remained patent. One patient was submitted to a major amputation. By life table analysis the cumulative primary and secondary patency and limb salvage rates for this group of diabetic patients were at 2 years 79.3%, 86.2% and 93.1% respectively (SE<10%).
Conclusions. This small experience and a review of the literature confirm the validity of the popliteal-to-distal bypass and the need for a more aggressive vascular surgical attitude to treat the ischemic diabetic foot.

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