Quality of Life in Patients Suffering from Critical Limb Ischemia

Steunenberg, Stijn L.; Raats, Jelle W; Slaa, Alexander te; Vries, Jolanda De; Laan, Lijckle van der

doi:10.1016/j.avsg.2016.05.087

Cited by 28 publications

(28 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, critics say that CLI patients have poor health prospects and life expectancy, irrespective of the treatment mode, 40 and a focus on QoL research is needed to prescribe the ideal treatment for patients suffering from CLI. 41 This study adds more evidence to the scarce literature and LIBERTY data supporting a revascularization approach for CLI will likely be corroborated by the BEST-CLI trial 42 that compares surgical bypass and endovascular therapy in CLI patients and also provide data about the impact of these treatments on the QoL of the study population.…”

Section: Wound Healing On Target Limbmentioning

confidence: 63%

<p>One-Year Outcomes of Peripheral Endovascular Device Intervention in Critical Limb Ischemia Patients: Sub-Analysis of the LIBERTY 360 Study</p>

Mustapha¹,

Igyarto²,

O’Connor³

et al. 2020

VHRM

View full text Add to dashboard Cite

Background: High-risk patients with advanced peripheral artery disease (PAD), including critical limb ischemia (CLI), are often excluded from peripheral endovascular device intervention clinical trials, leading to difficulty in translating trial results into real-world practice. There is a need for prospectively assessed studies to evaluate peripheral endovascular device intervention outcomes in CLI patients. Methods: LIBERTY 360 is a prospective, observational, multi-center study designed to evaluate the procedural and long-term clinical outcomes of peripheral endovascular device intervention in real-world patients with symptomatic lower-extremity PAD. One thousand two hundred and four patients were enrolled and stratified based on Rutherford Classification (RC): RC2-3 (N=501), RC4-5 (N=603), and RC6 (N=100). For this sub-analysis, RC5 and RC6 patients (RC5-6; N=404) were pooled and 1-year outcomes were assessed. Results: Procedural complications rarely (1.7%) resulted in post-procedural hospitalization and 89.1% of RC5-6 patients were discharged to home. Considering the advanced disease state in RC5-6 patients, there was a high freedom from 1-year major adverse event rate of 65.5% (defined as target vessel revascularization, death to 30 days, and major target limb amputation). At 1 year, freedom from major amputation was 89.6%. Wounds identified at baseline on the target limb had completely healed in 172/243 (70.8%) of the RC5-6 subjects by 1 year. Additionally, the overall quality of life, as measured by VascuQoL, improved from baseline to 1 year. Conclusion: LIBERTY investigated real-world PAD patients with independent oversight of outcomes. This analysis of LIBERTY RC5-6 patients demonstrates that peripheral endovascular device intervention can be successful in CLI patients, with low rates of major amputation and improvement in wound healing and quality of life through 1-year follow-up. LIBERTY 360, https://clinicaltrials.gov/ct2/show/NCT01855412, ClinicalTrials.gov Identifier: NCT01855412.

show abstract

Section: Wound Healing On Target Limbmentioning

confidence: 63%

<p>One-Year Outcomes of Peripheral Endovascular Device Intervention in Critical Limb Ischemia Patients: Sub-Analysis of the LIBERTY 360 Study</p>

Mustapha¹,

Igyarto²,

O’Connor³

et al. 2020

VHRM

View full text Add to dashboard Cite

show abstract

“…The increased number of major limb amputations seen in this study may have a large impact on the functional outcome, quality of life, and should thus be prevented. 13 Finally, although social distancing is critical for eliminating the spread of the SARS-CoV-2 virus, patients should not have to be afraid to visit their physician. An accurate assessment of wounds and tissue loss is essential in these patients, through either high-quality electronic video or photo consultation or physical examination.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Lockdown Strategy on Vascular Surgery Practice: More Major Amputations than Usual

Schuivens

Buijs

Winter

et al. 2020

Annals of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

Background: The aim of this study is to investigate the impact of the coronavirus disease 2019 (COVID-19) lockdown period on the number and type of vascular procedures performed in the operating theater. Methods: A total of 38 patients who underwent 46 vascular procedures during the lockdown period of March 16th until April 30th, 2020, were included. The control groups consisted of 29 patients in 2019 and 54 patients in 2018 who underwent 36 and 66 vascular procedures, respectively, in the same time period. Data were analyzed using SPSS Statistics. Results: Our study shows that the lockdown during the COVID-19 pandemic resulted in a significant increase in the number of major amputations (42% in 2020 vs. 18% and 15% in 2019 and 2020, respectively; P-value 0.019). Furthermore, we observed a statistically significant difference in the degree of tissue loss as categorized by the Rutherford classification (P-value 0.007). During the lockdown period, patients presented with more extensive ischemic damage when than previous years. We observed no difference in vascular surgical care for patients with an aortic aneurysm. Conclusions: Measurements taken during the lockdown period have a significant effect on noneCOVID-19 vascular patient care, which leads to an increased severe morbidity. In the future, policy makers should be aware of the impact of their measurements on vulnerable patient groups such as those with peripheral arterial occlusive disease. For these patients, medical care should be easily accessible and adequate.

show abstract

“…Quality of life following an amputation has been shown to be largely dependent on the ability to ambulate or return to previous functional status. [76][77][78][79] These findings stress the importance of postamputation care and rehabilitation to regain mobility and maintain independence. In addition to quality of life, many studies have found increased rates of depression following amputation.…”

Section: The Impact and Outcomes Of Major Amputationmentioning

confidence: 99%

The Role of Lower Extremity Amputation in Chronic Limb-Threatening Ischemia

2020

View full text Add to dashboard Cite

Chronic limb-threatening ischemia (CLTI) is a severe form of peripheral artery disease associated with high rates of limb loss. The primary goal of treatment in CLTI is limb salvage via revascularization. Multidisciplinary teams provide improved care for those with CLTI and lead to improved limb salvage rates. Not all patients are candidates for revascularization, and a subset will require major amputation. This article highlights the role of amputations in the management of CLTI, and describes the patients who should be offered primary amputation.

show abstract

Quality of Life in Patients Suffering from Critical Limb Ischemia

Cited by 28 publications

References 31 publications

<p>One-Year Outcomes of Peripheral Endovascular Device Intervention in Critical Limb Ischemia Patients: Sub-Analysis of the LIBERTY 360 Study</p>

<p>One-Year Outcomes of Peripheral Endovascular Device Intervention in Critical Limb Ischemia Patients: Sub-Analysis of the LIBERTY 360 Study</p>

Impact of the COVID-19 Lockdown Strategy on Vascular Surgery Practice: More Major Amputations than Usual

The Role of Lower Extremity Amputation in Chronic Limb-Threatening Ischemia

Contact Info

Product

Resources

About