PMID- 32945173
OWN - NLM
STAT- MEDLINE
DCOM- 20210127
LR  - 20210127
IS  - 1940-1574 (Electronic)
IS  - 0003-3197 (Linking)
VI  - 72
IP  - 2
DP  - 2021 Feb
TI  - Impact of the Timing of Foot Tissue Resection on Outcomes in Patients Undergoing 
      Revascularization for Chronic Limb-Threatening Ischemia.
PG  - 159-165
LID - 10.1177/0003319720958554 [doi]
AB  - The objective of this study is to describe utilization of revascularization and 
      tissue resection in patients with chronic limb-threatening ischemia (CLTI) and 
      determine whether the timing of resection impacts outcomes. Revascularizations 
      for CLTI were queried (ACS-NSQIP 2011-2015). Outcomes included 30-day major 
      adverse limb events (MALE), major adverse cardiac events (MACE), length of stay 
      (LOS), operative time, 30-day readmissions, and wound infections. Groups included 
      revascularization alone, revascularization/tissue resection during the same 
      procedure (concurrent), or revascularization/delayed tissue resection (delayed). 
      Resections were debridement or transmetatarsal amputations. Multivariate logistic 
      regression determined risk-adjusted effects of tissue resection on outcomes. 
      There was no difference in overall 30-day MACE or MALE between groups (P = .70 
      and P = .35, respectively). Length of stay (6.1 days revascularization alone vs 
      7.8 days concurrent vs 8.7 days delayed, P < .0001) was longer in patients who 
      underwent any tissue resection. Highest 30-day readmission and operative time was 
      the concurrent group (P = .02 and P < .0001, respectively). Wound infection was 
      highest in the delayed group (1.4% revascularization alone vs 1.3% concurrent vs 
      6.2% delayed, P < .0001). After risk adjustment, timing of resection did not 
      impact LOS for concurrent and delayed groups compared to revascularization alone 
      (both P < .0001). Debridement and minor amputations can be done concurrently in 
      patients undergoing revascularization for CLTI.
FAU - Shannon, Alexander H
AU  - Shannon AH
AUID- ORCID: 0000-0003-2236-3120
AD  - Department of Surgery, 12350University of Virginia, Charlottesville, VA, USA.
FAU - de Grijs, Derek P
AU  - de Grijs DP
AD  - Division of Vascular and Endovascular Surgery, 12350University of Virginia, 
      Charlottesville, VA, USA.
FAU - Goudreau, Bernadette J
AU  - Goudreau BJ
AUID- ORCID: 0000-0002-2954-113X
AD  - Department of Surgery, 12350University of Virginia, Charlottesville, VA, USA.
FAU - Mehaffey, J Hunter
AU  - Mehaffey JH
AD  - Department of Surgery, 12350University of Virginia, Charlottesville, VA, USA.
FAU - Cullen, J Michael
AU  - Cullen JM
AUID- ORCID: 0000-0002-2225-9879
AD  - Department of Surgery, 12350University of Virginia, Charlottesville, VA, USA.
FAU - Williams, Carlin
AU  - Williams C
AD  - Division of Vascular and Endovascular Surgery, 12350University of Virginia, 
      Charlottesville, VA, USA.
FAU - Robinson, William P 3rd
AU  - Robinson WP 3rd
AD  - Division of Vascular Surgery, East Carolina University, Greenville, NC, USA.
LA  - eng
GR  - T32 HL007849/HL/NHLBI NIH HHS/United States
GR  - U01 HL088925/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20200918
PL  - United States
TA  - Angiology
JT  - Angiology
JID - 0203706
SB  - IM
MH  - Adult
MH  - Aged
MH  - Chronic Disease
MH  - Endovascular Procedures/methods
MH  - Female
MH  - Humans
MH  - Ischemia/complications/*etiology
MH  - Length of Stay/statistics & numerical data
MH  - Lower Extremity/*physiopathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/*complications/physiopathology
MH  - Postoperative Complications/*etiology
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Vascular Grafting/methods
OTO - NOTNLM
OT  - length of stay
OT  - limb ischemia
OT  - major adverse cardiac events
OT  - major adverse limb events
OT  - revascularization
OT  - tissue resection
EDAT- 2020/09/19 06:00
MHDA- 2021/01/28 06:00
CRDT- 2020/09/18 08:42
PHST- 2020/09/19 06:00 [pubmed]
PHST- 2021/01/28 06:00 [medline]
PHST- 2020/09/18 08:42 [entrez]
AID - 10.1177/0003319720958554 [doi]
PST - ppublish
SO  - Angiology. 2021 Feb;72(2):159-165. doi: 10.1177/0003319720958554. Epub 2020 Sep 
      18.