Pedal Bypass in the Treatment
of the Critically Ischemic Diabetic Foot
Tošenovský P., Janoušek L., Adamec M., Jirkovská A. 1
Klinika cévní a transplantační chirurgie IKEM, Praha, přednosta doc. MUDr. M. Ryska, CSc. 1 Klinika diabetologie IKEM, Praha |
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Summary:
A formerly established theory on obliteration of diabetic foot arteries was dismissed.
In the last decade, diabetic foot revascularization using so called very distal bypass has become
a routine procedure. The reconstructions are undertaken in patients with chronic critical limb
ischemia. This paper presents our initial experience with this, not yet widely used, operative
technique in 16 patients who had a total of 14 pedal bypass procedures performed. The parame-
ters we monitored included the 3-, 6-, and 12-month patency rates, defect healing, and limb
salvage rates. The primary and secondary patency rates were 64.3 % and 78.6 % at 3 months;
55.5 % and 66.7 % at 6 months; and 50 % and 75 % at one year, respectively. The overall limb
salvage rate for the above periods was 92.9 %. All defects healed following successful revasculari-
zation using pedal bypass. In patients where bypass could not be established, limb salvage was
accomplished in one in three cases only.
Key words:
Pedal bypass - Diabetic foot - Critical ischemia - Patency rates.
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