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Titolo:
RESULTS AND COST-ANALYSIS OF DISTAL [CRURAL PEDAL] ARTERIAL REVASCULARIZATION FOR LIMB SALVAGE IN DIABETIC AND NONDIABETIC PATIENTS/
Autore:
PANAYIOTOPOULOS YP; TYRRELL MR; ARNOLD FJL; KORZONBURAKOWSKA A; AMIEL SA; TAYLOR PR;
Indirizzi:
GUYS HOSP,DEPT SURG,2ND FLOOR,NEW GUYS HOUSE,ST THOMASS ST LONDON SE19RT ENGLAND GUYS HOSP,DEPT SURG LONDON SE1 9RT ENGLAND
Titolo Testata:
Diabetic medicine
fascicolo: 3, volume: 14, anno: 1997,
pagine: 214 - 220
SICI:
0742-3071(1997)14:3<214:RACOD[>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOWER-EXTREMITY ISCHEMIA; VEIN GRAFT RECONSTRUCTION; INFRAINGUINAL BYPASS; AUTOGENOUS VEIN; FOOT ISCHEMIA; PATENCY; OUTFLOW; DISEASE; REHABILITATION; AMPUTATION;
Keywords:
SURGERY; LIMB SALVAGE; FEMORODISTAL BYPASS; INFRAPOPLITEAL BYPASS; CRITICAL LIMB ISCHEMIA; DIABETES; AMPUTATION; COST-EFFECTIVENESS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
41
Recensione:
Indirizzi per estratti:
Citazione:
Y.P. Panayiotopoulos et al., "RESULTS AND COST-ANALYSIS OF DISTAL [CRURAL PEDAL] ARTERIAL REVASCULARIZATION FOR LIMB SALVAGE IN DIABETIC AND NONDIABETIC PATIENTS/", Diabetic medicine, 14(3), 1997, pp. 214-220

Abstract

In order to compare the outcome and costs of femorodistal grafting indiabetic and nondiabetic patients presenting with critical limb ischaemia we analysed a consecutive series of 109 femorodistal bypasses, 38(35 %) performed on people with diabetes and 71 (65 %) on non-diabetic patients. The same aggressive revascularization policy was used in both groups with the decision to operate based on the presence of a calf or foot vessel on preoperative intra-arterial digital subtraction angiography (IADSA). Data were collected prospectively and the median follow-up was 15.4 months (range 0 to 42 months). There were no significant differences in 30-day (5.3 % vs 4.2 %) and in-hospital mortality (13.2 % vs 14.1 %) between the two groups. Life table curves at 3 yearsin diabetic and non-diabetic patients showed 48 % vs 60 % survival, 76 % vs 72 % knee salvage, 45 % vs 56 % limb salvage, and 38 % vs 47 % secondary patency. Although there was a trend far diabetic patients toperform less well, there was no statistically significant difference in these outcome measures, in cost comparison the only significant difference was found in the total hospital cost, which was pound 9181 in diabetic, compared to pound 6350 in nondiabetic patients (p = 0.026, Mann-Whitney). However, this cost was significantly less than that of primary amputation in either group (pound 15500 and pound 12040, respectively). Femorodistal reconstruction in both diabetic and non-diabeticpatients, whenever feasible, is a cheaper option than primary amputation, even though, vascular surgery may be more expensive in people with diabetes.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 23:21:37