Intestinal epithelial cells of the neonatal rat Invest. 1995Invest. . 95:2397Invest. -2402

the latest primary care consultation and CV assessment are shown in Table 1. Whilst 2175 (66.7%) underwent a primary care consultation within 7-30 days of index, only 416 (12.8%) had a CV-assessment during the same period. Furthermore, 2073 (63.6%) patients had no CV-assessment within the 3 months prior to their amputation. Of this group, 1230 (59.3%) still underwent a primary care consultation for another reason in the 7-30 days prior to their amputation. Conclusion: 'Missed opportunities' for timely diagnosis of CLTI within general practice potentially exist. Further investigation is required to greater understand the reasoning for these opportunities being missed and to develop strategies to that would help prevent amputation.

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Background: This retrospective comparative cohort study evaluated the clinical outcome of angiosome-guided endovascular arterial reconstructions in chronic limb-threatening ischemia (CLTI) due to multilevel peripheral artery disease (PAD). Methods: Patients treated in an endovascular fashion for CLTI with tissue loss due to multilevel PAD were analyzed. Limbs were classified as having undergone either angiosome-guided (direct) revascularization (DR) or nonangiosomic (indirect) revascularization (IR). DR was defined as uninterrupted in-line flow to the affected angiosome, revascularization through the pedal arch was also considered direct. Groups were adjusted with propensity score (PS) matching and compared for amputation-free survival (AFS), freedom from major adverse limb events (MALE), and healing rate at 12 months. Results: A total of 174 patients (81 men, mean age 70.0 ± 10.4 y) were included. PS matching produced two groups of 55 patients each: DR (24 men, mean age 71.7 ± 10.7 y) and IR (26 men, mean age 72.0 ± 9.4 y). The matched groups had no significant differences in baseline variables. At 12 months there were no significant differences in AFS (73.2% vs 71.6%; p = 0.841), freedom from MALE (71.7% vs 66.1%; p = 0.617), and healing rate (72.7% vs 72.0%; p = 1.000) between DR and IR, respectively. Conclusion: This study failed to support the use of angiosome concept in CLTI due to multilevel disease.

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