PMID- 31629123
OWN - NLM
STAT- MEDLINE
DCOM- 20200831
LR  - 20221207
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 64
DP  - 2020 Apr
TI  - Comparison of Cryopreserved Arterial Allografts Versus Heparin-bonded Vascular 
      Grafts in Infragenicular Bypass for Chronic Limb Threatening Ischemia.
PG  - 33-42
LID - S0890-5096(19)30840-4 [pii]
LID - 10.1016/j.avsg.2019.09.003 [doi]
AB  - BACKGROUND: The purpose of this study was to compare cryopreserved arterial 
      allograft (CAA) to heparin-bonded prosthesis (HBP) in infragenicular bypasses for 
      patients with chronic limb-threatening ischemia (CLTI). METHODS: This 
      retrospective study took place in 2 university hospitals and included 41 
      consecutive patients treated for CLTI. In the absence of a suitable saphenous 
      vein, an infragenicular bypass was performed using either CAA (24 cases) or HBP 
      (17 cases). Kaplan-Meyer analysis compared primary and secondary patency and 
      amputation-free survival rates. Binomial logistic regression analyzed risk 
      factors for major amputation and thrombosis. RESULTS: The mean followup was 
      18.5 months (+/-14.3) in the CAA group, 17.6 (+/-6.1) in the HBP group. In the CAA 
      group, primary and secondary patency rates at 12 months were 52% (+/-10.6) and 61% 
      (+/-10.3), compared to 88% (+/-7.8) and 94% (+/-5.7) in the HBP group, respectively. 
      The difference in patency rates was not statistically different (P = 0.27 and 
      P = 0.28, respectively). The statistically significant factors of graft 
      thrombosis were, a stage 4 from the WIfI classification (Wound Ischemia foot 
      Infection) with a 6 times higher risk (P = 0.04), and a distal anastomosis on a 
      leg artery with a 9 times higher risk of thrombosis (P = 0.03). Amputation-free 
      survival rates at 18 months were similar between the groups (CCA: 75% (+/-9) versus 
      HBP: 94% (+/-6), P = 0.11). Patients classified as WIfI stage 4 had 13 times higher 
      odds to undergo major amputation than patients with WIfI stage 2 or 3 (95% CI, 
      1.16-160.93; P = 0.04). The intervention was longer in the CCA group of 74 min 
      (278 min +/- 86) compared to the HBP group (203 min +/- 69). This difference was 
      statistically significant (95% CI, 17.86-132.98), t(35) = 2.671, P = 0.01. 
      CONCLUSIONS: CCA is not superior to HBP in infragenicular bypasses for CLTI, and 
      may not be worth the extra cost and the longer operative duration.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Hirth-Voury, Audrey
AU  - Hirth-Voury A
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Nice, 
      France; Universite Cote d'Azur, Medical school, Nice, France.
FAU - Massiot, Nicolas
AU  - Massiot N
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Reims, Nice, 
      France; Universite de Reims Champagne-Ardenne, Medical school, Reims, France.
FAU - Giauffret, Emmanuelle
AU  - Giauffret E
AD  - Universite Cote d'Azur, Medical school, Nice, France; Vascular Laboratory, Centre 
      Hospitalier Universitaire de Nice, Nice, France.
FAU - Behets, Charlotte
AU  - Behets C
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Reims, Nice, 
      France; Universite de Reims Champagne-Ardenne, Medical school, Reims, France.
FAU - Duprey, Ambroise
AU  - Duprey A
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Reims, Nice, 
      France; Universite de Reims Champagne-Ardenne, Medical school, Reims, France.
FAU - Hassen-Khodja, Reda
AU  - Hassen-Khodja R
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Nice, 
      France; Universite Cote d'Azur, Medical school, Nice, France.
FAU - Jean-Baptiste, Elixene
AU  - Jean-Baptiste E
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Nice, 
      France; Universite Cote d'Azur, Medical school, Nice, France.
FAU - Sadaghianloo, Nirvana
AU  - Sadaghianloo N
AD  - Departement of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Nice, 
      France; Universite Cote d'Azur, Medical school, Nice, France. Electronic address: 
      sadaghianloo.n@chu-nice.fr.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20191016
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
RN  - 0 (Anticoagulants)
RN  - 0 (Coated Materials, Biocompatible)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Allografts
MH  - Amputation, Surgical
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - *Bioprosthesis
MH  - *Blood Vessel Prosthesis
MH  - Blood Vessel Prosthesis Implantation/adverse effects/*instrumentation
MH  - Chronic Disease
MH  - *Coated Materials, Biocompatible
MH  - Cryopreservation
MH  - Female
MH  - France
MH  - Graft Occlusion, Vascular/etiology/physiopathology/surgery
MH  - Heparin/*administration & dosage/adverse effects
MH  - Humans
MH  - Ischemia/diagnostic imaging/physiopathology/*surgery
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/diagnostic imaging/physiopathology/*surgery
MH  - Progression-Free Survival
MH  - Prosthesis Design
MH  - Reoperation
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thrombosis/etiology/physiopathology/surgery
MH  - Time Factors
MH  - Vascular Patency
EDAT- 2019/10/20 06:00
MHDA- 2020/09/01 06:00
CRDT- 2019/10/20 06:00
PHST- 2019/06/23 00:00 [received]
PHST- 2019/09/12 00:00 [revised]
PHST- 2019/09/12 00:00 [accepted]
PHST- 2019/10/20 06:00 [pubmed]
PHST- 2020/09/01 06:00 [medline]
PHST- 2019/10/20 06:00 [entrez]
AID - S0890-5096(19)30840-4 [pii]
AID - 10.1016/j.avsg.2019.09.003 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2020 Apr;64:33-42. doi: 10.1016/j.avsg.2019.09.003. Epub 2019 Oct 
      16.