Objective: To assess the influence of diabetes mellitus (DM) and end-stage renal failure on hemodialysis (HD) on the healing time of tissue lesions and blood flow to the foot following a paramalleolar bypass in patients with critical limb ischemia (CLI).
Methods: Consecutive patients with CLI and tissue loss (24 limbs) were followed up retrospectively after paramalleolar bypass, and the healing time of tissue lesions, graft patency, limb salvage and survival rates were analyzed. The blood flow to the foot was assessed by skin perfusion pressure (SPP) pre- and postoperatively. The delta SPP was calculated as the difference between the SPP before and after bypass. The patients were divided into 3 groups: diabetic (DM, n = 9); diabetic and end-stage renal failure on hemodialysis (HD, n = 10); or neither (n = 5).
Results: A total of 15 dorsal and 9 plantar artery bypasses were performed. The median follow-up was 7.3 months (range, 1-18 months). No patients required major amputations, and all tissue lesions healed. The mean duration to complete tissue healing of the DM, HD and neither groups was 2.2, 2.5 and 1.2 months, respectively, was and these were not statistically significant. A significant improvement in the delta SPP after paramalleolar bypass was observed in the neither group compared with both the DM and HD groups.
Conclusion: Blood flow to the foot was not sufficiently improved in CLI patients with DM and HD, despite paramalleolar bypass. This may be the cause of the prolonged tissue healing duration of CLI patients with DM and HD. (English Translation of Jpn J Vasc Surg 2012; 21: 91-95).
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793181 | PMC |
| http://dx.doi.org/10.3400/avd.oa.13-00059 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Midterm Outcomes and Predictors of Failure of Lower Extremity Bypass to Para-Malleolar and Pedal Targets.
Ann Vasc Surg
September 2024
Division of Vascular Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA; Charleston Area Medical Center, Charleston, WV.
Background: The frequency of distal lower extremity bypass (LEB) for infrapopliteal critical limb threatening ischemia (IP-CLTI) has significantly decreased. Our goal was to analyze the contemporary outcomes and factors associated with failure of LEB to para-malleolar and pedal targets.
Methods: We queried the Vascular Quality Initiative infrainguinal database from 2003 to 2021 to identify LEB to para-malleolar or pedal/plantar targets.
A Novel Graft Route by Passage under the Achilles Tendon in Paramalleolar Distal Bypass Using the Small Saphenous Vein.
Ann Vasc Dis
March 2023
Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan.
Article Synopsis
- - A 77-year-old man with diabetes and renal dysfunction needed surgery for gangrene in his left toe, as he was on hemodialysis.
- - Since his great saphenous veins were previously used for heart surgery, surgeons utilized the small saphenous vein for a bypass procedure to restore blood flow.
- - After performing a minor amputation and employing negative pressure wound therapy, the patient's wounds healed completely within two months.
Tension-Free Management of Surgical Wound in Paramalleolar Bypass.
Ann Vasc Dis
September 2020
Department of Plastic Surgery, Shinsuma General Hospital.
: In paramalleolar bypass for critical limb-threatening ischemia (CLTI), excessive skin tension may occur for the closure of surgical wounds around the ankle. Furthermore, these surgical incisions are often proximal to infectious ischemic ulcers. Wound dehiscence caused by skin tension and surgical site infection carries a risk of graft exposure, anastomotic disruption, or graft insufficiency.
View Article and Find Full Text PDFInframalleolar Bypass to the Distal Portion of the Lateral Tarsal Artery for Limb Salvage.
Ann Vasc Dis
March 2019
Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan.
A 72-year-old man was admitted to our hospital due to rest pain and gangrene on his left second foot digit. Angiography revealed continuous patency from the superficial femoral artery stent to the below-knee popliteal artery with a diffuse, occlusive lesion in the crural arteries. The distal portion of the lateral tarsal artery was patent.
View Article and Find Full Text PDFOutcomes of Duplex-Guided Paramalleolar and Inframalleolar Bypass in Patients with Critical Limb Ischemia.
Ann Vasc Surg
November 2018
Vascular Surgery, University of Bologna, DIMES, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
Background: The aim of the study was to evaluate the outcomes of duplex ultrasonography (DUS)-guided autologous vein bypass to paramalleolar (distal third of tibial arteries and peroneal artery) and inframalleolar arteries (dorsalis pedis, common plantar, medial, and lateral plantar arteries) in patients with critical limb ischemia (CLI) and extensive tibial artery disease Trans-Atlantic Inter-Society Consensus D.
Methods: Between January 2007 and October 2016, all paramalleolar or inframalleolar bypasses performed in patients with CLI, planned only on the basis of DUS, were collected and analyzed retrospectively. DUS evaluation included arterial disease extension, inflow and outflow arteries' diameter, outflow vessels resistance, and autologous veins quality.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!