Limb Salvage in End-Stage Renal Disease (ESRD): Comparison of Modern Results in Patients With and Without ESRD

James M. Edwards, Lloyd M. Taylor, John M. Porter

    Research output: Contribution to journalArticlepeer-review

    100 Scopus citations

    Abstract

    We reviewed our experience with femoral-popliteal-tibial reversed vein bypasses performed for limb salvage in 226 patients without and 19 patients with end-stage renal disease (ESRD). While 18-month primary patency rates were comparable (85% and 89%), limb salvage was significantly lower (76% vs 95%) in patients with ESRD. Five amputations in the ESRD group were required for nonhealing, large foot ulcers in diabetic patients despite patent arterial bypass while only five of 13 amputations in patients without ESRD were required in the presence of patent grafts. The need for major amputation despite patent bypass in diabetic patients with ESRD who have extensive foot gangrene or ischemic ulceration occurs sufficiently often that we recommend primary amputation be considered in these patients without regard to possible vascular reconstruction.

    Original languageEnglish (US)
    Pages (from-to)1164-1168
    Number of pages5
    JournalArchives of Surgery
    Volume123
    Issue number9
    DOIs
    StatePublished - Sep 1988

    ASJC Scopus subject areas

    • Surgery

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