Efficacy Outcomes of Endovascular Versus Surgical Revascularization in Critical Limb Ischemia: Results From a Prospective Cohort Study.

Schindewolf, Marc; Fuss, Torsten; Fink, Hanspeter; Gemperli, Armin; Haine, Axel; Baumgartner, Iris (2018). Efficacy Outcomes of Endovascular Versus Surgical Revascularization in Critical Limb Ischemia: Results From a Prospective Cohort Study. Angiology, 69(8), pp. 677-685. Sage 10.1177/0003319717750486

Full text not available from this repository. (Request a copy)

Data on efficacy outcomes of endovascular versus surgical revascularization in patients with critical limb ischemia (CLI) in contemporary practice are limited. In this prospective cohort study, 353 consecutive patients with CLI were enrolled and allocated to endovascular (PTA [percutaneous transluminal angioplasty]), surgical (SURG), or no revascularization (No REVASC) after interdisciplinary consensus. Outcome measures were sustained primary clinical success (sPCS; survival without major amputation, repeated target extremity revascularization, and freedom from CLI), limb salvage, and amputation-free survival. Propensity-matched Kaplan-Meier analyses and stratified log-rank tests were performed. The PTA, SURG, and No REVASC groups consisted of 264, 62, and 27 patients, respectively. Compared to SURG patients, PTA patients were significantly older, had more risk factors, and more often had ischemic lesions. Propensity score-adjusted analyses showed no significant differences: sPCS was 51.3%/52.2%, limb salvage rate 91.5%/93.7%, and major amputation-free survival 90.5%/87.2% at 12 months for PTA and SURG, respectively. Amputation-free survival for the No REVASC group was 69% at 12 months. In conclusion, endovascular and surgical revascularization in CLI has comparable efficacy outcomes after 12 months. Contemporary overall outcome of patients with CLI is considerably better compared to earlier studies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Schindewolf, Marc; Fuss, Torsten; Haine, Axel and Baumgartner, Iris

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0003-3197

Publisher:

Sage

Language:

English

Submitter:

Catherine Gut

Date Deposited:

11 Feb 2019 18:00

Last Modified:

20 Nov 2019 08:56

Publisher DOI:

10.1177/0003319717750486

PubMed ID:

29355026

Uncontrolled Keywords:

amputation angioplasty bypass surgery chronic critical limb ischemia outcome analysis peripheral artery disease

URI:

https://boris.unibe.ch/id/eprint/123389

Actions (login required)

Edit item Edit item
Provide Feedback