An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)

Jaff, Michael R.; White, Christopher J.; Hiatt, William R.; Fowkes, Gerry; Dormandy, J. A.; Razavi, Mahmood K.; Reekers, Jim A.; Norgren, Lars

doi:10.3400/avd.tasc.15-01000

Cited by 134 publications

(41 citation statements)

References 90 publications

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“…On the other hand, our average in-hospital costs of endovascular treatment for CLI ($4 763.72 per year and $13.05 per day), resulting in individually different amputation-free survival periods, were lower than the threshold for the estimation of the cost-effectiveness of medical intervention for one QALY, as determined in Poland in January 2016 at the level of 345.08 PLN ($88.48) per day. This means that lower limb revascularization and salvation, even for a limited amputation-free survival period, should be recognized as a worthwhile and cost-effective procedure, which is supported by other authors [5,[9][10][11][12][13]. The resource expenditure linked with endovascular procedures might be further decreased by the selective use of stents and other expensive devices [9,14].…”

Section: Discussionmentioning

confidence: 71%

“…Thus, a high percentage of CLI treatment fails and the lack of at least one-year of benefits from lower limb revascularization in 55% of patients with CLI may suggest that interventional therapy in patients with CLI is not cost-effective and leads only to ineffective resource utilization. In this context, in spite of endovascular therapy for lower limb ischemia being recognized as a significantly less costly procedure than surgery without significant differences in amputationfree survival [5], primary leg amputation in CLI patients might seem to be a better option for patients with CLI, especially in individuals for whom there are risk factors for poor treatment outcome [6]. However, such risk-factor scores for CLI have still not been published [7].…”

Section: Introductionmentioning

confidence: 99%

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Koszty szpitalnego leczenia z powodu krytycznego niedokrwienia kończyn dolnych u pacjentów, u których ostatecznie przeprowadzono amputację kończyny. Obserwacje z jednego ośrodka

Budzyński¹,

Wnęk

Banaś

et al. 2017

MBS

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S u m m a r y B a c k g r o u n d . Currently, the average amputation free survival in patients with critical limb ischemia (CLI) amounts to 76% after one year of follow-up. Such poor prognosis raises the question: is revascularization in patients with CLI cost-effective? The aim of this study was to conduct a cost analysis of vascular care in patients with CLI.The aim of this study was to conduct a cost analysis of vascular care in patients with CLI. P a t i e n t s a n d m e t h o d s . A retrospective cost analysis of in-hospital endovascular treatment in 37 patients with CLI who underwent secondary leg amputation between January 2012 and June 2015.R e s u l t s . The average length of time between the first endovascular procedure due to CLI and leg amputation amounted to 214 days (range 8-1088 days). The total cost of hospitalizations before leg amputation amounted to 687 603.13 PLN, which is, on average, 18 583.87 PLN per patient, and 86.84 PLN per person per day for living with the preserved lower limb. The total costs associated with the patients who had undergone leg amputation amounted to 404 883.24 PLN, which is an average of 10 942.79 PLN per patient. Previous endovascular procedures accounted for 58.9% of this sum and 37.1% to total management costs for the patients.C o n c l u s i o n s . The cost per day of endovascular treatment that makes it possible to live with two lower limbs did not exceed the established cost-effectiveness threshold. Lower limb amputation increases the costs of in-hospital patient care by 59%, represents financial wastage for the hospital, and incurs other costs not easily measured.S t r e s z c z e n i e W s t ę p . Obecnie około 76% pacjentów z krytycznym niedokrwieniem kończyn dolnych (KNKD) poddanych rewaskularyzacji przeżywa kolejny rok z zachowaną kończyną.Powstaje więc pytanie, czy zabiegi rewaskularyzacyjne u tych pacjentów są efektywne kosztowo, skoro 24% chorych nie korzysta z ich efektów dłużej niż przez rok? Celem niniejszej pracy była analiza kosztów opieki naczyniowej u pacjentów z KNKD.P a c j e n c i i m e t o d y . Retrospektywna analiza kosztów szpitalnego leczenia angiologicznego KNKD u 37 pacjentów poddanych wtórnej amputacji kończyny w okresie 01.2012 -06.2015. W y n i k i . Średni okres między pierwszym zabiegiem rewaskularyzacyjnym a amputacją tej kończyny wynosił 214 dni (przedział 8-1088dni). Całkowite koszty hospitalizacji związanych z zabiegami wewnątrznaczyniowymi przed amputacją kończyny wyniosły 687 603,13PLN, co średnio na pacjenta daje 18 583,87 PLN, 86,84 PLN za jeden dzień i 18 578,5 PLN za potencjalny rok życia z kończyną. Na koszty te składały się koszty stałe oraz zmienne, związane DOI: http://dx.doi.org/10.12775/MBS.2016.029 Jacek Budzyński et al. 14 głównie z liczbą implantowanych stentów (n=59) i leczeniem trombolitycznym (n=6). Natomiast całkowity koszt hospitalizacji związanych z amputacją kończyny dolnej wynosił w badanej grupie 404 883.24 PLN, co daje średnio 10 942,79 PLN na pacjenta. Suma ta stanowiła 58,9% kosztów wcześniejszych...

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Koszty szpitalnego leczenia z powodu krytycznego niedokrwienia kończyn dolnych u pacjentów, u których ostatecznie przeprowadzono amputację kończyny. Obserwacje z jednego ośrodka

Budzyński¹,

Wnęk

Banaś

et al. 2017

MBS

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“…Our sample reported smoking 04 cases (44.4%), lipid metabolism disorders has 08 cases (88.9%). According to other documents [2,3], smoking and lipid metabolic disorders becomes a factor accelerating the process of pathological blood vessels, increases the severity of the disease and significant impact on disease chronic arterial occlusion of the lower extremities.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Endovascular Intervention Therapy Results in Chronic Below-The-Knee (BTK) Arterial Occlusive Disease

Le¹

2016

Angiol

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Objective: To evaluate the results of endovascular intervention therapy in Below-The-Knee (BTK) arterial disease. Methods:Retrospective descriptive series of cases. We had researched from January 2015 to December 2015 at Vascular Surgery department in Cho Ray hospital.Results: The study sample of 09 patients. We had counted 55.6% female rates, average ages 74.56 ± 9.7. Chief complain symptom was a painfully, 66.6% sample. Percutaneous transluminal angioplasty (PTA) performed by 77.8%, PTA and stent replacement combination accounted for 22.2%. BTK intervention simple accounted for 66.7%, other combination was 33.3%. The procedure times had 161 ± 38.7 minutes. The time of hospitalization average was 6 ± 1.85 days. Thrombosis artery complications had got into 11.1%, hematoma had got 11.1% and mortality rate had got 1 case in our research. Technique and short-term results success rates were 88.9% and 88.9%, respectively. Conclusions:The intervention endovascular therapy of chronic arterial occlusion of the lower extremity less invasive method which is safe, effective, shorter hospital stays and faster recovery of patients. Results of short-term achieve a high success rate.

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“…Beyond high-performance techniques in reconstructing arterial flow [72][73][74][75][76][77][78][79][80][81][82][83][84][85][86], new strategies about "when" and "where" to perform appropriate revascularization emerge today [1,27,30,35]. Contemporary practitioners equally avail key data on the molecular mechanisms generating ischemic threat and tissue regeneration [59][60][61].…”

Section: New Strategies For "Wound Targeted Revascularization"mentioning

confidence: 99%

Ischemic Ulcer Healing: Does Appropriate Flow Reconstruction Stand for All That We Need?

Alexandrescu¹,

Triffaux²

2016

Wound Healing - New Insights Into Ancient Challenges

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During the recent decades, soaring progresses in vascular disease knowledge, particularly in critical limb ischemia (CLI) treatment, enhanced novel diagnostic and interventional strategies with high serviceableness in patient's selection, arterial recanalization, and dedicated ischemic ulcer follow-up. However, despite undeniable advances in medical technology and clinical judgment, limb salvage, the ambulation recovery, and patient's survival seem only scarcely affected in this heterogeneous CLI group, particularly concerning the diabetic and renal patients. Innovative strategies such as "end artery occlusive disease" treatment or "wound-targeted revascularization" were equally proposed by following the angiosomal anatomical distribution associating individual foot collateral assessment in a unified macro-and micro-circulatory judgment. However, despite encouraging clinical results, prospective evidence still lacks on this concern. It also appears that specific wounds could not always stand for the lowest perfusion areas according to current CLI criteria, since severe neuropathy, inflammatory swelling, local infection, and skin trauma may add complementary hindrances to tissue viability.The present chapter endeavor to summarize main available treatment principles for ischemic ulcer recovery that every modern practitioner eventually disposes in an updated contemporary view."

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An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)

Cited by 134 publications

References 90 publications

Koszty szpitalnego leczenia z powodu krytycznego niedokrwienia kończyn dolnych u pacjentów, u których ostatecznie przeprowadzono amputację kończyny. Obserwacje z jednego ośrodka

Koszty szpitalnego leczenia z powodu krytycznego niedokrwienia kończyn dolnych u pacjentów, u których ostatecznie przeprowadzono amputację kończyny. Obserwacje z jednego ośrodka

Evaluation of Endovascular Intervention Therapy Results in Chronic Below-The-Knee (BTK) Arterial Occlusive Disease

Ischemic Ulcer Healing: Does Appropriate Flow Reconstruction Stand for All That We Need?

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