TY - JOUR
T1 - Comparative study of venous arterialization and pedal bypass in a patient cohort with critical limb ischemia
AU - Schreve, Michiel A.
AU - Minnee, Robert C.
AU - Bosma, Jan
AU - Leijdekkers, Vanessa J.
AU - Idu, Mirza M.
AU - Vahl, Anco C.
PY - 2014
Y1 - 2014
N2 - Patients with critical limb ischemia (CLI) have a poor life expectancy, and aggressive revascularization is accepted as a means to maintain their independence in the end stage of life. The goal of this case-control study was to evaluate the clinical outcome of distal venous arterialization and compare this with pedal bypass surgery in patients with CLI, and to identify potential risk factors that could be used to effectively identify patients at high risk of graft occlusion and amputation. A retrospective cohort of patients was treated for CLI using venous arterialization or pedal bypass between 2007 and 2012. Kaplan-Meier and Cox regression analyses were used to evaluate predictors for limb salvage and patency. In 40 patients with CLI, 21 venous arterializations and 19 pedal bypasses were performed. In the venous arterialization group, early occlusion was 15%, 1-year patency was 71%, and limb salvage was 53%. In the PB group, early occlusion was 23%, one-year patency was 75% and limb salvage was 47%. The only independent risk factor for limb salvage in multivariate analysis was bypass occlusion (P <0.001). Limb salvage after venous arterialization was equal to limb salvage after pedal bypass surgery in this clinical comparative study
AB - Patients with critical limb ischemia (CLI) have a poor life expectancy, and aggressive revascularization is accepted as a means to maintain their independence in the end stage of life. The goal of this case-control study was to evaluate the clinical outcome of distal venous arterialization and compare this with pedal bypass surgery in patients with CLI, and to identify potential risk factors that could be used to effectively identify patients at high risk of graft occlusion and amputation. A retrospective cohort of patients was treated for CLI using venous arterialization or pedal bypass between 2007 and 2012. Kaplan-Meier and Cox regression analyses were used to evaluate predictors for limb salvage and patency. In 40 patients with CLI, 21 venous arterializations and 19 pedal bypasses were performed. In the venous arterialization group, early occlusion was 15%, 1-year patency was 71%, and limb salvage was 53%. In the PB group, early occlusion was 23%, one-year patency was 75% and limb salvage was 47%. The only independent risk factor for limb salvage in multivariate analysis was bypass occlusion (P <0.001). Limb salvage after venous arterialization was equal to limb salvage after pedal bypass surgery in this clinical comparative study
U2 - https://doi.org/10.1016/j.avsg.2013.08.010
DO - https://doi.org/10.1016/j.avsg.2013.08.010
M3 - Article
C2 - 24189192
SN - 0890-5096
VL - 28
SP - 1123
EP - 1127
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
IS - 5
ER -