PMID- 32339688
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20221207
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 68
DP  - 2020 Oct
TI  - Endovascular Therapy Provides Similar Results of Bypass Graft Surgery in the 
      Treatment of Infrainguinal Multilevel Arterial Disease in Patients with Chronic 
      Limb-Threatening Ischemia in All GLASS Stages.
PG  - 400-408
LID - S0890-5096(20)30347-2 [pii]
LID - 10.1016/j.avsg.2020.04.028 [doi]
AB  - BACKGROUND: Extensive infrainguinal arterial disease still pose a challenge for 
      technical and clinical success of percutaneous angioplasty. The purpose of this 
      study was to compare the results of concomitant femoropopliteal and 
      infrapopliteal percutaneous angioplasty/stenting (PTA/S) with distal bypass graft 
      surgery (BGS) in patients with chronic limb-threatening ischemia (CLTI). METHOD: 
      In a single-center retrospective investigation between 2011 and 2017, 668 
      revascularization procedures for CLTI were reviewed. Concomitant femoropopliteal 
      and infrapopliteal disease was identified in 153 CLTI patients, treated with BGS 
      (48) using autogenous veins as substitute or PTA/S in a single procedure (105). A 
      subgroup of patients with complex, extensive arterial lesions (GLASS stage III) 
      received additional analysis. Primary outcomes were limb salvage and survival. 
      RESULTS: The mean follow-up time was 21.4 months. Patients treated with PTA/S 
      were significantly older and with predominance of females, diabetes and chronic 
      kidney disease. Smoking was more common in patients treated with BGS. The BGS 
      group showed a 36-month survival rate of 73.4%, whereas the PTA/S group presented 
      a survival of 61.3% in the same interval (P = 0.25). The 36-month cumulative limb 
      salvage rate was 53.3 and 59.7% for BGS and PTA/S, respectively (P = 0.24). For 
      GLASS stage III patients, 36-month limb salvage rates were 54.4% for the PTA/S 
      group and 50.2% for the BGS group (P = 0.29). Multivariate analysis pointed poor 
      runoff status (all endovascular patients) and diabetes (GLASS III endovascular 
      patients) as risk factors for limb loss. CONCLUSION: PTA/S and BGS presented 
      similar results of limb salvage and survival in the treatment of concomitant 
      femoropopliteal and infrapopliteal arterial disease in patients with CLTI, even 
      for patients with extensive and complex arterial disease.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Casella, Ivan Benaduce
AU  - Casella IB
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil. Electronic address: 
      ivan.c@hc.fm.usp.br.
FAU - Sartori, Camila Holanda
AU  - Sartori CH
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil.
FAU - Faustino, Carolina Brito
AU  - Faustino CB
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil.
FAU - Vieira Mariz, Maria Paula
AU  - Vieira Mariz MP
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil.
FAU - Presti, Calogero
AU  - Presti C
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil.
FAU - Puech-Leao, Pedro
AU  - Puech-Leao P
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil.
FAU - De Luccia, Nelson
AU  - De Luccia N
AD  - Vascular Surgery Division, Clinics Hospital of the Faculty of Medicine, 
      University of Sao Paulo, Sao Paulo, Brazil.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20200425
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Amputation, Surgical
MH  - *Angioplasty/adverse effects/instrumentation/mortality
MH  - Chronic Disease
MH  - Female
MH  - Femoral Artery/diagnostic imaging/physiopathology/*surgery
MH  - Humans
MH  - Ischemia/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Popliteal Artery/diagnostic imaging/physiopathology/*surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Saphenous Vein/*transplantation
MH  - Stents
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Vascular Grafting/adverse effects/mortality
MH  - Vascular Patency
EDAT- 2020/04/28 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/04/28 06:00
PHST- 2020/04/07 00:00 [received]
PHST- 2020/04/13 00:00 [revised]
PHST- 2020/04/14 00:00 [accepted]
PHST- 2020/04/28 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/04/28 06:00 [entrez]
AID - S0890-5096(20)30347-2 [pii]
AID - 10.1016/j.avsg.2020.04.028 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2020 Oct;68:400-408. doi: 10.1016/j.avsg.2020.04.028. Epub 2020 
      Apr 25.