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December 1969

Femoral Grafts in DiabeticsResulting Conservative Amputations

Author Affiliations

From the Surgical Services of the New England Deaconess Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston.

Arch Surg. 1969;99(6):776-780. doi:10.1001/archsurg.1969.01340180100020

The diabetic patient, particularly if his primary disease has been poorly regulated, comes to face many problems. One of the more serious of these concerns the circulation to the lower extremity, which all too frequently deteriorates to such an extent that a major amputation becomes necessary. The pathologic changes in the artery wall of diabetics and nondiabetics are similar—but the former group is prone to develop occlusions in the arteries below the knee level. This is shown by the common occurrence of gangrene in the diabetic with a good popliteal pulse (40% of all diabetics seen). Obviously, if a combination of femoral occlusion and poor tibial arteries exists, serious trouble results—a fact which accounts for the high incidence of ischemic rest pain and gangrene in the patients who require femoral artery grafts. In addition, the diabetic has more generalized arteriosclerotic changes in the femoral and popliteal arteries, is less able

Brands, L.C.:  Long-Term Results of Autogenous Venous By-pass Grafts in the Femoro-Popliteal Segment , J Cardiovasc Surg 8:472-477 ( (Nov) -Dec) 1967.
Darling, R.C.; Linton, R.R.; and Razzuk, M.A.:  Saphenous Vein By-pass Grafts for Femoro-Popliteal Occlusive Disease , Surgery 61:31-40 ( (Jan) ) 1967.
De Weese, J.A., et al:  Autogenous Venous By-pass Grafts and Thromboendarterectomies for Atherosclerotic Lesions of the Femoro-Popliteal Artery , Ann Surg 163:205-214 ( (Feb) ) 1966.Article
Kouchoukos, N.T., et al:  Operative Therapy for Femoral-Popliteal Arterial Occlusive Disease , Circulation 35 (suppl 1):174-182 ( (April) ) 1967.Article
Kaplitt, M.J., et al:  Review of Femoro-Popliteal Reconstructions Utilizing Gas Endarterectomy , Surgery 62:872-883 ( (Nov) ) 1967.
Vollmar, J., et al:  Principles of Reconstructive Procedures for Chronic Femoro-Popliteal Occlusions , Ann Surg 168:215-223 ( (Aug) ) 1968.Article
Sawyer, P.N., et al:  Analysis of Peripheral Gas Endarterectomy in 127 Patients , Arch Surg 97:859-863 ( (Dec) ) 1968.Article
Burke, J.F.:  The Effective Period of Preventive Antibiotic Action in Experimental Incisions and Dermal Lesions , Surgery 50:161-168, 184-185 ( (July) ) 1961.
Edwards, W.S.:  Venous Patch Graft Reconstruction of Chronic Femoral-Popliteal Occlusions , Surgery 61:820-822 ( (May) ) 1967.
Stokes, J.M.; Sugg, W.L.; and Butcher, H.B.:  Standard Method of Assessing Relative Effectiveness of Therapies for Arterial Occlusive Disease , Ann Surg 157:343-350 ( (March) ) 1963.Article