Foot revascularisation in the diabetic with severe tibial artery disease - abstract
West Indian med. j
; West Indian med. j;46(Suppl. 2): 36, Apr.1997.
Article
em En
| MedCarib
| ID: med-2463
Biblioteca responsável:
JM3.1
Localização: JM3.1; R18.W4
ABSTRACT
It is commonly believed that diabetics have "small vessel" disease causing severe ischaemia and gangrene foot. This is supported by the fact that, often enough, such patients have a popliteal pulse. In most centres world-wide, these patients are not offered revascularisation options and lose their limbs. Recently, there have been a few reports supporting the value of tibial artery bypass in diabetes with infrapopliteal arterial disease. We have used short vein bypasses in 12 diabetic patients with a palpable popliteal pulse, no distal pulses and limb-threatening ischaemia in the foot. Bypasses were done to the dorsalis pedis, plantar arteries or posterior tibial at the ankle using the popliteal or posterior tibial as the inflow source. Eleven of the 12 limbs were salvaged in the immediate post-operative period and another graft occlusion at 18 months resulted in below-knee amputation. We recommended that diabetics with limb-threatening foot ischaemiaand a palpable popliteal pulse should be carefully investigated by arteriography and Doppler, and distal bypass should be performed whenever possible. Because of the large diabetic population in the Caribbean and because of the morbidity and mortality of major amputations we feel that, wherever possible, limb salvage efforts should be made. Infrapopliteal vascular reconstruction in the diabetic can certainly save many limbs currently amputated because of tibial artery disease. (AU)
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Coleções:
01-internacional
Base de dados:
MedCarib
Assunto principal:
Artérias da Tíbia
/
Pé Diabético
Limite:
Humans
País/Região como assunto:
Caribe ingles
/
Trinidad y tobago
Idioma:
En
Revista:
West Indian med. j
Ano de publicação:
1997
Tipo de documento:
Article
/
Congress and conference