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C C Paniszyn

Publications and source records attributed to C C Paniszyn.

5 recordsLinked to original sources
PubMed1990

Results of vein graft reconstruction of the lower extremity in diabetic and nondiabetic patients.

The results of 171 vein grafts of the lower extremity were evaluated. These were placed between January 1981 and December 1987 in 150 patients, 75 diabetic and 75 nondiabetic, to determine the influence of diabetes on the outcome of the procedure. One and four year patency rates were determined by a life table analysis. No statistical differences in primary patency were found between the patients with diabetes and those without diabetes for all indications of operations (one year, diabetic patients 95 +/- 3 per cent, nondiabetic patients 85 +/- 3 per cent; four years, diabetic patients 89 +/- 11 per cent and nondiabetic patients 80 +/- 12 per cent; p = n.s.). For those operated upon for salvage of the limb because of rest pain, ulceration or gangrene, patency in diabetic patients at one year approached a statistically significant advantage (diabetic patients 94 +/- 4 per cent versus nondiabetic patients 79 +/- 8 per cent; p = 0.056). We believe that arterial reconstruction of the lower extremity can be performed upon patients with diabetes with the same high degree of success for revascularization and salvage of the limb as can be accomplished in nondiabetic patients. This is true even though those with diabetes present with necrosis of the tissue and more often require bypass to distal tibial arteries.

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PubMed1989

Symptomatology and anatomic patterns of peripheral vascular disease: differing impact of smoking and diabetes.

We retrospectively examined the impact of smoking and diabetes on the clinical presentation and arteriographic pattern of occlusion in 227 patients evaluated for symptomatic infrainguinal arterial disease. The age at which significant symptomatology developed did not differ for diabetics and nondiabetics. Diabetics had significantly more occlusion in the large arteries of the calf, however, particularly in the peroneal and posterior tibial arteries. Despite this, the extent of occlusive disease in the pedal arch was not influenced by diabetes. Diabetics also tended to present more frequently with gangrene or ulcer (greater than 70%) when compared to nondiabetic smokers (41%, p less than .01). Smokers presented with symptomatic disease earlier than nonsmokers (p less than .0005). Intermittent claudication was strongly associated with smoking; among 33 patients with claudication, 32 were smokers. In contrast to the effect of diabetes, smokers appeared to have less extensive occlusive disease in the large arteries of the calf than nonsmokers. Nondiabetic nonsmokers constituted less than 10% of our study population and presented at a significantly older age. Nevertheless, despite the absence of either risk factor, this group also tended to present with gangrene or ulcer relatively frequently (71%). Although diabetes and smoking are both risk factors for atherosclerotic disease, we conclude that their impact on the angiographic pattern of occlusion and clinical presentation differs substantially.

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