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Dorsalis pedis bypass heals ischemic ulcers. (Use Saphenous Vein).

BOSTON -- Bypass of a diseased dorsalis pedis artery in the foot can often resolve ischemic ulcers, even in patients with diabetes.

"Bypass grafting of the dorsalis pedis is safe, durable, and effective, and ... diabetes does not adversely affect the outcome of the procedure," Dr. Frank B. Pomposelli said at the joint annual meeting of the American Association for Vascular Surgery and the Society for Vascular Surgery.

"Our results justify the routine use of pedal arterial reconstruction for diabetic patients with ischemic foot complications," said Dr. Pomposelli, a vascular surgeon at Beth Israel Deaconess Medical Center in Boston.

During 199 0-2000, Dr. Pomposelli and his associates did a dorsalis pedis bypass on 864 patients, of whom 794 (92%) had diabetes. A nonhealing foot ulcer was present in 809 patients. The immediate goal of bypass surgery was to restore a palpable foot pulse to these patients.

The mean follow-up of these patients was 24 months, with some patients followed for as long as 10 years. At 5 years of follow-up, 63% of the bypass vessels maintained secondary patency and limbs were successfully salvaged in 78% of the patients. Patency was better in men than in women.

The best results were seen in patients who received saphenous vein bypasses. At 5 years, the secondary patency rate in these vessels was 68%. In a multivariate analysis, use of a saphenous vein as the bypass vessel was associated with an 82% increase in long-term patency compared with other types of bypass vessels.
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Author:Zoler, Mitchel L.
Publication:Internal Medicine News
Date:Sep 1, 2002
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