Blood Flow in the Diabetic Leg

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Abstract
Femoropopliteal bypass grafting with reversed saphenous vein was performed in 47 nondiabetic and 27 diabetic extremities. Graft flow was measured with an electromagnetic flow probe before and after injection of 15 mg of papaverine into the graft. Basal flow (nondiabetic, 74 ± 6; diabetic, 76 ± 11 ml/min) was similar in the two groups. Peak flow was significantly higher in the nondiabetic group (217 ± 14 ml/min) than in the diabetic group (169 ± 18 ml/min, P < 0.05), and the outflow tract was significantly better in the nondiabetics (12.2 ± 0.5) than in the diabetics (8.6 ± 0.7, P < 0.001). When flow was related to the quality of the outflow tract, there was no significant difference between nondiabetics and diabetics. Diabetics with occlusive vascular disease have greater involvement of the tibial and peroneal arteries than do nondiabetics. Vascular reactivity is not significantly impaired, and arterial reconstruction should not be withheld on the basis of anteriolar-capillary involvement.