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Comparable Results in Diabetics

Frederick F. Bartlett, MD; Gary W. Gibbons, MD; Frank C. Wheelock, Jr, MD

Arch Surg. 1986;121(10):1150-1153.

Abstract
• The case reports of 100 consecutive patients receiving aortic bifurcation grafts strictly for occlusive disease were reviewed. Fifty-seven diabetics and 43 nondiabetics constituted the study group. Mean age and preoperative risk factors were otherwise comparable. Sixty-eight percent of operations in diabetics were for limb salvage as compared with 47% in the nondiabetic group. All 100 patients survived the operation and left the hospital with open grafts. The complication rate was similar in both groups. Mean follow-up was 48 months in the diabetic group vs 58 months in the nondiabetic group. Thirty-three percent of the diabetics were dead at four years, a survival rate one half of that of the nondiabetics. Nine percent of patients in each group suffered late limb graft occlusions, a cumulative graft patency of 94% at five years. Limb loss and subsequent distal reconstruction were comparatively low although higher in the diabetic group. This suggests more and progressive distal arterial disease in the diabetics and not an unsuccessful inflow procedure. We conclude that aortic reconstruction can be safely carried out in diabetics with high graft patency and limb salvage rates.

(Arch Surg 1986;121:1150-1153)

Author Affiliations
From the Department of Surgery, New England Deaconess Hospital and Joslin Diabetes Center, and the Harvard Medical School, Boston.

Footnotes
Accepted for publication Nov 14, 1985.

Reprint requests to 110 Francis St, Suite 5D, Boston, MA 02215 (Dr Gibbons).

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