PMID- 32633651
OWN - NLM
STAT- MEDLINE
DCOM- 20201102
LR  - 20221207
IS  - 1545-1550 (Electronic)
IS  - 1526-6028 (Linking)
VI  - 27
IP  - 4
DP  - 2020 Aug
TI  - Bypass Grafting vs Endovascular Therapy in Patients With Non-Dialysis-Dependent 
      Chronic Kidney Disease and Chronic Limb-Threatening Ischemia (CRITISCH Registry).
PG  - 599-607
LID - 10.1177/1526602820938465 [doi]
AB  - Purpose: To report the outcomes of bypass grafting (BG) vs endovascular therapy 
      (EVT) in patients with non-dialysis-dependent chronic kidney disease (CKD) and 
      chronic limb-threatening ischemia (CLTI). Materials and Methods: The CRITISCH 
      Registry is a prospective, national, interdisciplinary, multicenter registry 
      evaluating the current practice of all available treatment options in 1200 
      consecutive CLTI patients. For the purposes of this analysis, only the 337 
      patients with non-dialysis-dependent CKD treated by either BG (n=86; median 78 
      years, 48 men) or EVT (n=251; median age 80 years, 135 men) were analyzed. The 
      primary composite outcome was amputation-free survival (AFS); secondary outcomes 
      were overall survival (OS) and amputation-free time (AFT). All outcomes were 
      evaluated in Cox proportional hazards models; the results are reported as the 
      hazard ratio (HR) and 95% confidence interval (CI). Results: The Cox regression 
      analysis revealed a significantly greater hazard of amputation or death after BG 
      (HR 1.78, 95% CI 1.05 to 3.03, p=0.028). The models for AFT and overall survival 
      also suggested a higher hazard for BG, but the differences were not significant 
      (AFT: HR 1.66, 95% CI 0.78 to 3.53, p=0.188; OS: HR 1.41, 95% CI 0.80 to 2.47, 
      p=0.348). The absence of runoff vessels (HR 1.73, 95% CI 1.15 to 2.60, p=0.008) 
      was associated with a decreased AFS. The likelihood of amputation was higher in 
      male patients (HR 2.21, 95% CI 1.10 to 4.45, p=0.027) and was associated with a 
      lack of runoff vessels (HR 1.95, 95% CI 0.96 to 3.95, p=0.065) and myocardial 
      infarction (HR 3.74, 95% CI 1.23 to 11.35, p=0.020). Death was more likely in 
      patients without runoff vessels (HR 1.76, 95% CI 1.11 to 2.80, p=0.016) and those 
      with a higher risk score (HR 1.73, 95% CI 1.03 to 2.91, p=0.038). Conclusion: 
      This analysis suggested that BG was associated with poorer AFS than EVT in 
      patients with non-dialysis-dependent CKD and CLTI. Male sex, previous myocardial 
      infarction, and the absence of runoff vessels were additionally identified as 
      predictors of poorer outcomes.
FAU - Stavroulakis, Konstantinos
AU  - Stavroulakis K
AUID- ORCID: 0000-0002-9775-9210
AD  - Department of Vascular Surgery, St. Franziskus Hospital Munster, Germany.
AD  - Department of Vascular Surgery, Ludwig-Maximilians-University Hospital, Munich, 
      Germany.
FAU - Gkremoutis, Asimakis
AU  - Gkremoutis A
AD  - Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, 
      UK.
FAU - Borowski, Matthias
AU  - Borowski M
AD  - Institute of Biostatistics and Clinical Research, Westfalische 
      Wilhelms-Universitat Munster, Germany.
FAU - Torsello, Giovanni
AU  - Torsello G
AUID- ORCID: 0000-0001-7513-5063
AD  - Department of Vascular Surgery, St. Franziskus Hospital Munster, Germany.
FAU - Bockler, Dittmar
AU  - Bockler D
AD  - Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 
      Germany.
FAU - Zeller, Thomas
AU  - Zeller T
AUID- ORCID: 0000-0003-2704-3871
AD  - Clinic Cardiology and Angiology II, Universitats-Herzzentrum Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Steinbauer, Markus
AU  - Steinbauer M
AD  - Department of Vascular Surgery, Barmherzige Brueder Regensburg, Germany.
FAU - Tsilimparis, Nikolaos
AU  - Tsilimparis N
AD  - Department of Vascular Surgery, Ludwig-Maximilians-University Hospital, Munich, 
      Germany.
FAU - Bisdas, Theodosios
AU  - Bisdas T
AD  - Department of Vascular Surgery, St. Franziskus Hospital Munster, Germany.
AD  - Department of Vascular and Endovascular Surgery, Athens Medical Center, Athens, 
      Greece.
CN  - CRITISCH Collaborators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200707
PL  - United States
TA  - J Endovasc Ther
JT  - Journal of endovascular therapy : an official journal of the International 
      Society of Endovascular Specialists
JID - 100896915
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation, Surgical
MH  - Chronic Disease
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - Female
MH  - Germany/epidemiology
MH  - Humans
MH  - Ischemia/diagnosis/mortality/*therapy
MH  - Limb Salvage
MH  - Male
MH  - Peripheral Arterial Disease/diagnosis/mortality/*therapy
MH  - Prospective Studies
MH  - Registries
MH  - Renal Insufficiency, Chronic/diagnosis/mortality/*therapy
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Vascular Grafting/adverse effects/mortality
OTO - NOTNLM
OT  - amputation
OT  - amputation-free survival
OT  - bypass grafting
OT  - chronic kidney disease
OT  - critical limb ischemia
OT  - endovascular therapy
OT  - mortality
FIR - Adili, Farzin
IR  - Adili F
FIR - Balzer, Kai
IR  - Balzer K
FIR - Billing, Arend
IR  - Billing A
FIR - Brixner, Daniel
IR  - Brixner D
FIR - Debus, Sebastian E
IR  - Debus SE
FIR - Florek, Hans-Joachim
IR  - Florek HJ
FIR - Grundmann, Reinhardt
IR  - Grundmann R
FIR - Hupp, Thomas
IR  - Hupp T
FIR - Keck, Tobias
IR  - Keck T
FIR - Gerss, Joachim
IR  - Gerss J
FIR - Wojciech, Klonek
IR  - Wojciech K
FIR - Lang, Werner
IR  - Lang W
FIR - May, Bjorn
IR  - May B
FIR - Meyer, Alexander
IR  - Meyer A
FIR - Muhling, Bernhard
IR  - Muhling B
FIR - Oberhuber, Alexander
IR  - Oberhuber A
FIR - Reinecke, Holger
IR  - Reinecke H
FIR - Reinhold, Christian
IR  - Reinhold C
FIR - Ritter, Ralf-Gerhard
IR  - Ritter RG
FIR - Schelzig, Hubert
IR  - Schelzig H
FIR - Schlensack, Christian
IR  - Schlensack C
FIR - Schmitz-Rixen, Thomas
IR  - Schmitz-Rixen T
FIR - Schulte, Karl-Ludwig
IR  - Schulte KL
FIR - Spohn, Matthias
IR  - Spohn M
FIR - Storck, Martin
IR  - Storck M
FIR - Trede, Matthias
IR  - Trede M
FIR - Uhl, Christian
IR  - Uhl C
FIR - Weis-Muller, Barbara
IR  - Weis-Muller B
FIR - Wenk, Heiner
IR  - Wenk H
FIR - Zhorzel, Sven
IR  - Zhorzel S
FIR - Zimmermann, Alexander
IR  - Zimmermann A
EDAT- 2020/07/08 06:00
MHDA- 2020/11/03 06:00
CRDT- 2020/07/08 06:00
PHST- 2020/07/08 06:00 [pubmed]
PHST- 2020/11/03 06:00 [medline]
PHST- 2020/07/08 06:00 [entrez]
AID - 10.1177/1526602820938465 [doi]
PST - ppublish
SO  - J Endovasc Ther. 2020 Aug;27(4):599-607. doi: 10.1177/1526602820938465. Epub 2020 
      Jul 7.