Successful short bypass to dorsalis pedis artery in a diabetic patient

Can Çağlar Erdem, Nobuyoshi Azuma, Akira Nagamine, Keijiro Mitsube, Tadahiro Sasajima

Department of Surgery, Medicine Faculty of Asahikawa University, Japan

We report a 59-year-old diabetic male patient with a small but intractable ulcer on his right distal sole. Magnetic resonance angiography revealed disease-free peroneal and anterior tibial arteries continuing down to the ankle; however, plantar arteries were occluded at their point of origin and a short segment of proximal occlusion was found in the dorsalis pedis artery. The toe-systemic pressure index was 0.28, suggesting ischemia in the distal foot. A peroneal- dorsalis pedis arterial short bypass with an in-situ saphenous vein graft was performed; thereafter, the patient's ulcer regressed markedly. Present results justify an aggressive bypass strategy in patients with localized occlusive foot lesions.

Keywords : Critical limb ischemia; diabetic atherosclerosis; pedal bypass; prostaglandin E1

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