Why the study?
Does diabetes status affect patency, limb salvage, and survival rates in patients undergoing infrainguinal bypass surgery?
Does diabetes status affect patency, limb salvage, and survival rates in patients undergoing infrainguinal bypass surgery?
Following infrainguinal bypass surgery, diabetic patients have similar patency and limb salvage rates to non-diabetic patients, but experience significantly higher perioperative mortality and lower 3-year survival.
Diabetes associated with lower survival after infrainguinal bypass without worse limb outcomes; leaves open whether targeted interventions modify mortality risk.
In 92 diabetic and 175 non-diabetic patients undergoing 336 femoropopliteal or femorodistal bypass procedures, 1- and 3-year cumulative life-table patency, limb salvage, and survival rates were comparatively analysed. The peroperative mortality rate was significantly higher in diabetic patients (5% compared to 1.4%, p < 0.001). The cumulative graft patency rates were 61% at 12 months and 46% at 36 months in diabetic patients compared to 64 and 52% in non-diabetic patients. Significantly better patency rates were observed in limbs with good runoff compared to limbs with poor runoff in both groups. The limb salvage rates at 3 years were 70% in diabetic patients and 62% in non-diabetic patients. The survival rate at 3 years was significantly lower in diabetic patients, 62% compared to 86% in non-diabetic patients. Diabetic patients with poor runoff demonstrated a significantly lower survival rate after 36 months compared to diabetic patients with good runoff (48% and 74%, respectively). The results of this study demonstrate that the early and intermediate patency and limb salvage rates are similar in diabetic and non-diabetic patients. On the other hand the survival rate in diabetic patients, especially in those with poor distal runoff, is significantly lower than non-diabetic patients.
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Karacagil et al. (1995) studied this question.
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