Vascular evaluation and treatment of the diabetic.

Vascular reconstruction in the diabetic is not recommended for the occasional vascular surgeon. In general, diabetics are higher operative risk patients and the majority are undergoing revascularization because of severe ischemia associated with a limb-threatening foot infection. The success of each of our series represents a team approach with careful preoperative screening and intraoperative monitoring as well as a meticulous and precise operative technique. The diabetic's predilection for distal arterial occlusive disease, more extensive calcification, and poor collateral formation require the maximum skill and experience of the operating surgeon. The results support a continued aggressive approach to revascularization of the ischemic diabetic extremity.