Patients with diabetes and critical limb ischemia have a high peripheral vascular resistance

Results of infrainguinal bypass surgery may be better in diabetic patients compared with nondiabetic patients. One important determinator of outcome in these operations is the peripheral vascular resistance (PR). The aim of the present prospective study is to evaluate whether there is a difference in PR in diabetic and nondiabetic patients with critical limb ischemia. The two patient groups (n = 11 for each) were matched for toe pressure, age, gender, and outflow vessel. PR was measured intraoperatively during infrainguinal bypass surgery by controlled infusions of autologous blood. The resistance was significantly higher in the diabetic group (p < 0.05), as compared to the nondiabetic group. Except for fibrinogen that tended to be higher in diabetics (p = 0.07), blood parameters, blood pressures and angiographic scoring of run-off were similar in both groups. This finding of higher PR in diabetic patients with critical limb ischemia compared with matched nondiabetic ischemic patients suggests that a low PR is not the reason for the positive results of infrainguinal bypass surgery in diabetic patients.