A formerly established theory on obliteration of diabetic foot arteries was dismissed. In the last decade, diabetic foot revascularization using so called very distal bypass has became a routine procedure. The reconstructions are undertaken in patients with chronic critical limb ischemia. This paper presents our initial experience with this, not yet widely used, operative technique in 16 patients who had a total of 14 pedal bypass procedures performed. The parameters we monitored included the 3-, 6-, and 12-month patency rates, defect healing, and limb salvage rates. The primary and secondary patency rates were 64.3% and 78.6% at 3 months; 55.5% and 66.7% at 6 months; and 50% and 75% at one year, respectively. The overall limb salvage rate for the above periods was 92.9%. All defects healed following successful revascularization using pedal bypass. In patients where bypass could not be established, limb salvage was accomplished in one in three cases only.

Keywords: Adult; Aged; Aged, 80 and over; Diabetic Foot /complications/; Female; Foot /blood supply/; Humans; Ischemia /complications/; Male; Middle Aged; Vascular Surgical Procedures /methods/