Pedal bypass surgery after crural endovascular intervention

Uhl, Christian; Hock, Carolin; Betz, Thomas; Töpel, I.; Steinbauer, Markus

doi:10.1016/j.jvs.2013.11.071

Cited by 30 publications

(9 citation statements)

References 16 publications

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“…Some authors have evoked the negative impact of failed endovascular treatment on subsequent bypasses, 16 which has not been confirmed by recent reports. 17,18 On the other hand, failure of bypass as a first line treatment has a poor prognosis too. Indeed, the 2 year limb salvage rate for occluded grafts performed for rest pain and tissue loss are 55% and 34%, respectively.…”

Section: Clinical Improvementmentioning

confidence: 99%

Treatment of TASC C and D Femoropoliteal Lesions with Paclitaxel eluting Stents: 12 month Results of the STELLA-PTX Registry

Davaine

Quérat

Kaladji

et al. 2015

European Journal of Vascular and Endovascular Surgery

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Section: Clinical Improvementmentioning

confidence: 99%

Treatment of TASC C and D Femoropoliteal Lesions with Paclitaxel eluting Stents: 12 month Results of the STELLA-PTX Registry

Davaine

Quérat

Kaladji

et al. 2015

European Journal of Vascular and Endovascular Surgery

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“…The "endo first" philosophy has been shown to be effective in previous studies from this institution 15,16 and is also established elsewhere 17 ; it now gains some further confirmation since there was no significant difference in the wound healing or AFS between patients who underwent OS after failed ET and those undergoing OS as the first line treatment. However, LS was inferior among these patients undergoing OS as a second or third revascularisation as was the LS in patients undergoing solely ET, results both possibly affected by the longer delay from referral to successful revascularisation.…”

Section: Discussionmentioning

confidence: 58%

Analysis of the Elective Treatment Process for Critical Limb Ischaemia with Tissue Loss: Diabetic Patients Require Rapid Revascularisation

Noronen

Saarinen

Albäck

et al. 2017

European Journal of Vascular and Endovascular Surgery

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“…28 In general, studies showing equivocal results between the groups tended to be smaller, single centre studies, which may have been underpowered to show a difference. 11,19,21,22,24,25,28 Multiple factors have been implicated in explaining why patients who have failed an endovascular intervention might have worse outcomes after subsequent bypass. Some authors have argued that this results from loss of potential outflow vessels during the initial endovascular procedure, which may impact the choice and location of distal targets during subsequent bypass.…”

Section: Primary Bypass Bypass After Failed Evt Odds Ratio Weight M-hmentioning

confidence: 99%

Editor's Choice – Infrainguinal Bypass Following Failed Endovascular Intervention Compared With Primary Bypass: A Systematic Review and Meta-Analysis

Hossain

Leblanc

Farber

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS This is the first systematic review of primary infrainguinal bypass after previous failed endovascular interventions for infrainguinal peripheral arterial disease. Pooled data of 11,886 patients shows improved one year amputation free survival in the patients who had primary bypass (OR 1.61; 95% CI 1.14e2.29) compared with patients who had bypass after failed endovascular therapy. There was also a trend towards higher rates of graft occlusion and worse one year primary patency for patients with prior failed endovascular intervention. Objectives: Patients with infrainguinal peripheral arterial disease often undergo multiple revascularisation procedures. Although many centres have adopted an endovascular first approach, some are reluctant to do so for fear of compromising the outcomes of any subsequent bypasses. All studies that compared the outcomes of primary infrainguinal bypass with bypass after failed endovascular intervention were analysed. Methods: A systematic review was conducted of MEDLINE, EMBASE, and CENTRAL databases for studies comparing outcomes of primary infrainguinal bypass with bypass after failed endovascular intervention for peripheral arterial disease. Abstracts and full text studies were screened independently by two reviewers with data abstraction done in duplicate. Dichotomous outcome measures were reported using the OR and 95% CI, and pooled using random effects models. Results: Abstracts were screened (2,528), with 50 selected for full text review. Of these, 15 studies involving 11,886 patients met the inclusion criteria. Pooling the results of studies comparing primary bypass with bypass after failed endovascular intervention showed no significant difference in 30 day mortality (OR 1.00; 95% CI 0.65e1.54), or 30 day amputation rates (OR 1.26; 95% CI 0.95e1.65). Interestingly, one year amputation free survival was higher in the patients who had primary bypass (OR 1.30; 95% CI 1.10e1.52) compared with patients who had bypass after failed endovascular therapy. There was also worse one year primary patency (OR 1.65; 95% CI 1.04e2.62) for patients with prior failed endovascular intervention. The review demonstrated a trend towards higher rates of early graft occlusion (OR 4.54; 95% CI 0.97e21.28). Conclusions: Meta-analysis of the existing literature comparing primary bypass with bypass following failed endovascular intervention shows worse one year amputation free survival and worse primary patency in those patients who undergo bypass after failed endovascular intervention. There is also a trend towards higher rates of early graft occlusion, although these results were not statistically significant. These conclusions are limited by observational study design, inconsistent patient selection, and significant heterogeneity between studies.

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Pedal bypass surgery after crural endovascular intervention

Cited by 30 publications

References 16 publications

Treatment of TASC C and D Femoropoliteal Lesions with Paclitaxel eluting Stents: 12 month Results of the STELLA-PTX Registry

Treatment of TASC C and D Femoropoliteal Lesions with Paclitaxel eluting Stents: 12 month Results of the STELLA-PTX Registry

Analysis of the Elective Treatment Process for Critical Limb Ischaemia with Tissue Loss: Diabetic Patients Require Rapid Revascularisation

Editor's Choice – Infrainguinal Bypass Following Failed Endovascular Intervention Compared With Primary Bypass: A Systematic Review and Meta-Analysis

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