Salvage of Extremities with Ischemic Necrosis in Diabetic Patients by Infrapopliteal Arterial Bypass

  1. Charles R Shuman
  1. Department of Surgery, Section of Peripheral Vascular Surgery, and the Department of Medicine, Metabolic Section, Temple University Health Sciences Center Philadelphia, Pennsylvania 19140


Initial and long-term limb salvage can be achieved by infrapopliteal bypass in diabetic patients with ischemic necrosis of the distal extremity. Mortality is low in all groups, and mortality of subsequent amputation apparently is not affected by the previous bypass. An adequate arteriogram and consideration of distal bypass are frequently indicated in the diabetic patients in whom ischemic necrosis is present. Limb salvage may be feasible even in those diabetic patients in whom popliteal artery is not patent on preoperative arteriogram by bypasses to anterior tibial, posterior tibial, or peroneal artery.

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