Efficacy of infrainguinal bypass for limb salvage in young diabetic patients

Impact of endovascular options on lower extremity revascularization in young patients

“…In two separate studies, serologic testing of young patients with premature PAD showed that approximately one-third may have a detectable hypercoagulable disorder. 14,15 Most reports on the outcomes of LER in patients with premature PAD focus on open interventions performed during the past century, 5,6,10,16 and very little has been written on endovascular therapy. 17 Here, we have described the results of contemporary open and percutaneous LER of a large group of patients with premature PAD from a single institution compared with a selected group of older controls.…”

“…The cutoff age was defined based on the available literature. 2,3,9,10 Recognizing the arbitrary definition of the cutoff age used, all patients with premature PAD were included and were further divided into two groups: group A (aged Յ50 years) and group B (aged 51-60 years). The control group included selected patients with comparable indications and types of interventions (open vs percutaneous) who underwent LER at age Ͼ60 (group C) during the same interval.…”

Patient Age and Patency Rate after Recanalization of Occluded Peripheral Arteries

“…While there are some data regarding age and peripheral surgical treatment, data regarding interventional treatment are sparse. In 31 young patients, with a mean age of 44 years, the 18-month primary patency rate after a surgical intervention was 60 8 11%, and the assisted primary patency rate was 78 8 9% [19] . Among 128 femoropopliteal and 99 femorotibial bypass grafts in 209 octogenarians, and 242 femoropopliteal and 166 femorotibial bypass grafts in 383 septuagenarians, the 5-year primary patency rates were 74% for octogenarians and 68% for septuagenarians (p 1 0.2) [20] .…”

Outcome of lower-extremity revascularization in patients younger than 40 years in a predominately diabetic population

“…Several investigators have found similar decreases in patency and limb salvage. 1,9,10,13,14 Toursarkissian et al 15 evaluated 31 patients younger than 50 years who had diabetes and were undergoing infrainguinal bypass grafting for limb salvage. They also found an acceptable rate of major complications, with comparable limb salvage rates.…”

“…The increased rate of multiple revascularization procedures and progression to amputation are consistent with findings of other studies. Toursarkissian et al 15 demonstrated an 18-month primary patency rate of 60% Ϯ 11% and a limb salvage rate of 71% Ϯ 9% in patients younger than 50 years. In addition, 5-year mortality in these young patients is as high as 17% to 26%.…”