Aortic reconstruction for occlusive disease. Comparable results in diabetics
F. F. Bartlett, G. W. Gibbons and F. C. Wheelock Jr
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.
