Effects Of Perioperative Risk For Femoral-popliteal Arterial Bypass Grafting In Patients With Type 2 Diabetes Mellitus

Objectives : to evaluate the effects of perioperative risk for femoral-popliteal arterial vascular prosthesis bypass grafting because of lower extremity arteriosclerosis obliterians in patients with type 2 diabetes mellitus.Materials and methods: We retrospectively analyzed 70 patients who underwent femoral-popliteal arterial bypass grafting between January 2004 and December 2007 in our hospital . The number of diabetic patients was 25 , including 14 male and 11 female(44%),and the mean age was 68.120±9.435years . The number of non-diabetic patients was 45,including 42 male and 3 female (6.7%) , and mean age was 70.78±9.332 years . The mean age of two groups has not significant difference (p > 0.05) , but the sex difference is significant (Female,DM group 44% vs. NDM group 6.7% , p = 0.0002) , history of smoking was significant higher in patients without diabetes (48%vs.84.4% , p = 0.0012) . The incidence of hypertension(DM group 60% vs. NDM group 62.2%,p > 0.05), stroke(4% vs. 8.9% , p > 0.05), arrhythmia (28% vs. 24.4%, p > 0.05) and history of ischemic heart disease (28% vs. 26.7%, p > 0.05) have not significant difference between two groups . Polytetrafluoroethylene (PTFE) blood vessel prostheses were used for all patients. Technique was femoral-popliteal bypass grafting and distal anastomotic stoma were above knees . Postoperative rate of cardiovascular complications , cerebrovascular complications, wound infection rate , graft failure , all caused death, total stay and postoperative stay were compared in patients with and without diabetes mellitus .Results: All operations succeeded . After surgery, the blood supply of extremities improved , the pressure of malleolus arteries increased . However , there was no significant difference between two groups ( p > 0.05 ) . There were no significant difference postoperatively in cardiovascular complication rate , graft failure and mortality between two groups ( p > 0.05) . However , for all length of hospital stay and postoperative stay, diabetic group was longer than that non-diabetic group ( p < 0.05 ) .Conclusions: After appropriate preoperative preparations , type 2 diabetic patients with lower extremity arteriosclerosis obliterians can get the same short-term outcomes with the non-diabetic patients managed by lower extremity vascular prosthesis bypass grafting .