Pedal bypass for limb salvage: Impact of diabetes on long-term outcome

Use of pedal bypass can salvage limbs of patients with critical ischemia. T he aim of this study was to evaluate the results of surgical revascularizat ion of pedal arteries in diabetic patients and to assess the impact of diab etes on long-term outcome. We performed a retrospective analysis of all con secutive pedal bypasses done between January 1, 1987 and December 31, 1997. Demographic data, surgical indications, operative variables, and postopera tive results including graft patency and limb salvage were compared between diabetic and nondiabetic patients. The results of this comparison showed t hat pedal bypass can safely and effectively relieve critical ischemia in di abetic patients. Diabetics have less early graft thrombosis and superior lo ng-term graft patency. Despite higher incidence of renal insufficiency or f ailure and more tissue loss, diabetics can achieve similar excellent limb s alvage rates. This outcome justifies aggressive revascularization of pedal arteries in diabetic as well as nondiabetic patients with critical limb isc hemia.