Hurley J J, Auer A I, Hershey F B, Binnington H B, Woods J J, Nunnelee J D, Milyard M K
J Vasc Surg. 1987 May;5(5):796-802.
Controversy regarding efficacy and durability of distal bypass grafting of the diabetic patient exists. A 22-year-long series of 259 vascular procedures with 100% follow-up (57% in diabetic individuals) is examined to compare these results with those of non-diabetic patients. Extensive review of predisposing factors, operative indications, preoperative medical evaluation, as well as techniques and peculiarities of angiography is rendered. Peripheral arterial case mix between the two groups is examined. The high utilization rate of solely venous conduits (94%) in diabetics compared with 76% in nondiabetics, along with anastomosis site selection, provides the most reasonable explanation for the successful outcome in both groups. Modifications in revascularization techniques contributing to successful outcome are presented. In the diabetic patients, both the cumulative graft patency rate (63%) and the limb salvage rate (77%) at 6 years were superior to those of the non-diabetics (52% and 65%, respectively). Diabetes mellitus does not predispose the person requiring revascularization for limb salvage to a lesser likelihood of success.
关于糖尿病患者远端旁路移植术的疗效和持久性存在争议。对长达22年的259例血管手术进行研究，随访率达100%（糖尿病患者中随访率为57%），并将这些结果与非糖尿病患者的结果进行比较。对诱发因素、手术指征、术前医学评估以及血管造影技术和特点进行了广泛回顾。对两组的外周动脉病例组合进行了检查。糖尿病患者单纯使用静脉导管的利用率很高（94%），而非糖尿病患者为76%，再加上吻合部位的选择，为两组手术的成功结果提供了最合理的解释。文中介绍了有助于取得成功结果的血运重建技术的改进。糖尿病患者6年时的移植血管累积通畅率（63%）和肢体挽救率（77%）均优于非糖尿病患者（分别为52%和65%）。糖尿病并不会使需要进行肢体挽救血运重建的患者成功的可能性降低。
