Outcome Analysis of Infrapopliteal Percutaneous Transluminal Angioplasty and Bypass Graft Surgery With Nonreversed Saphenous Vein for Individuals With Critical Limb Ischemia

Casella, Ivan Benaduce; Brochado-Neto, Francisco Cardoso; Sandri, Giuliano A.; Kalaf, Marcelo Jorge; Godoy, Maria de Fátima Guerreiro; Costa, V.S.; Matielo, Marcelo Fernando; Sacilotto, Roberto

doi:10.1177/1538574410373663

Cited by 29 publications

(16 citation statements)

References 35 publications

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“…Cependant, les taux de perméabilité secondaire et de sauvetage de jambe étaient plus élevés pour le pontage que pour l'angioplastie pour les patients avec des lésions TASC D à 12 mois de suivi (p = 0,04 et 0,01, respectivement) [27].…”

Section: Que Disent Les éTudes Qui Comparent Ces Deux Techniques ?unclassified

La revascularisation distale des diabétiques en ischémie critique

Courtois

Sapoval

Giudice

et al. 2015

Journal des Maladies Vasculaires

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Section: Que Disent Les éTudes Qui Comparent Ces Deux Techniques ?unclassified

La revascularisation distale des diabétiques en ischémie critique

Courtois

Sapoval

Giudice

et al. 2015

Journal des Maladies Vasculaires

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“…In the overall series and in the propensity score, matched pairs PTA and bypass surgery achieved similar 6 months leg salvage, survival and amputation-free survival rates. Both provide an acceptable limb salvage rate, but patency appears to be better after bypass surgery [1,9,15]. The greatest problem in treating lower limb ischaemia and trying to compare different methods of treatment is that it is very difcult to standardize the disease itself.…”

Section: Discussionmentioning

confidence: 99%

“…The limb salvage rate after PTA is higher than the angiographic patency rate. Patients with long lesions in infrapopliteal arteries are usually offered a bypass surgery [1]. Direct pedal bypass is performed most frequently.…”

Section: Introductionmentioning

confidence: 99%

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Blauzdos arterijų endovaskulinių procedūrų ir šuntų į pėdos arteriją rezultatų analizė

Navickienė¹,

Builytė²,

Kalinauskas³

2015

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ObjectivePercutaneous transluminal angioplasty (PTA) of crural arteries remains a valuable procedure for limb salvage in critical limb ischemia (CLI). Patients with anatomically unfavourable occlusive lesions of infrapopliteal arteries are usually offered a bypass surgery. The aims of this study were to report our experience, compare long-term results of surgical revascularization of pedal arteries and infrapopliteal PTA in patients with CLI, and assess the impact of diabetes mellitus and the type of treatment on limb salvage rates. Methods All tibial interventions to treat CLI, which were performed during the period of January 1999 to December 2013, were retrospectively analysed. The outcomes of tibial PTA procedures and open surgery -bypasses to dorsal pedal artery (DP) -were compared. The impact of diabetes mellitus control on the primary revascularization procedures' outcomes was analysed. Results Three patient groups were formed: the open repair group (treated by dorsal pedal artery bypass operation) -193 patients, the endovascular repair group -103 limbs in 98 patients, and the combined treatment group (endovascular repair and dorsal pedal artery bypass) -84 patients. The cumulative patency rate in the open repair group at a 1-year period was 47.5%, in the endovascular repair group -6.9% and in the combined treatment group -79.6%. The best results of revascularization were achieved in the combined treatment group (p < 0.007). The limb salvage rate at the 1-year follow-up was 84.1% in the open repair group, 35.4% in the endovascular repair group, and 83.1% in the combined treatment group. In the combined treatment group, limbs were saved for a longer period (p < 0.01). The patency rates for DP artery bypasses at the 1-year follow-up in diabetic patients were 60.4%, in non-diabetic patients -21.8% (p = 0.013), and for PTA procedures in diabetic patients -3.6%, in non-diabetic -10.1%. The patency rate in patients under tight plasma glucose control was 55.2%, in uncontrolled diabetes group -43.6% after two years. The limb salvage rate in patients under a tight plasma glucose control was 79.31%, in uncontrolled diabetes group -61.82% after two years. These findings had no significance (p > 0.05). Originalūs mokslo tiriamieji darbai 150A . N a v i c k i e n ė , U . B u i l y t ė , G . K a l i n a u s k a s ConclusionBoth infrapopliteal angioplasty and bypass surgery provide an acceptable limb salvage rate, but the follow-up patency appears to be better after bypass surgery. The duration of revascularization in the open repair group was longer as compared to the endovascular repair group. The best revascularization results were in diabetic patients after open surgery combined with PTA (combined treatment group). DP artery bypass is a safe and durable procedure in patients with CLI and patients with diabetes mellitus. Tight plasma glucose levels control has no effect on primary revascularization outcomes. Key words: percutaneous transluminal angioplasty (PTA), dorsalis pedis artery (DP) bypass, critical limb ische...

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“…Studies have found similar outcomes between angioplasty and bypass for infrapopliteal TASC A, B, and C lesions; however, outcomes are not as favorable for TASC D lesions. 10,11 As technology for infrapopliteal angioplasty and stents improves, it is possible that the proportion of interventions performed with endovascular techniques will increase, approaching that seen with femoral-popliteal disease.…”

Section: It Ismentioning

confidence: 98%

The impact of endovascular procedures on fellowship training in lower extremity revascularization

Nandivada

Lagisetty

Giles

et al. 2012

Journal of Vascular Surgery

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The number of procedures performed during vascular residency has dramatically increased over the last decade secondary to the increased number of endovascular procedures. The average vascular surgery resident's open operative experience has been stable over the last 10 years, despite the increasing endovascular case volume. Residents perform femoral endarterectomy with increasing frequency, perhaps representing an increasing volume of hybrid procedures. Gaps in information available for evaluating resident training remain a significant obstacle. Moving forward, revision of the current reporting system to a format that more accurately reflects resident experience would be beneficial.

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Outcome Analysis of Infrapopliteal Percutaneous Transluminal Angioplasty and Bypass Graft Surgery With Nonreversed Saphenous Vein for Individuals With Critical Limb Ischemia

Abstract: Both BGS and PTA provided similar results of patency and limb salvage for individuals with infrapopliteal atherosclerotic disease presenting with CLI. Bypass graft surgery had better results than PTA when TASC D lesions were present.

Cited by 29 publications

References 35 publications

La revascularisation distale des diabétiques en ischémie critique

La revascularisation distale des diabétiques en ischémie critique

Blauzdos arterijų endovaskulinių procedūrų ir šuntų į pėdos arteriją rezultatų analizė

The impact of endovascular procedures on fellowship training in lower extremity revascularization

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