PMID- 33308022
OWN - NLM
STAT- MEDLINE
DCOM- 20211210
LR  - 20221207
IS  - 1799-7267 (Electronic)
IS  - 1457-4969 (Linking)
VI  - 110
IP  - 2
DP  - 2021 Jun
TI  - Outcome after Hybrid Outflow Interventions for Chronic Limb-threatening Ischemia.
PG  - 241-247
LID - 10.1177/1457496920975608 [doi]
AB  - BACKGROUND AND AIMS: Because chronic limb-threatening ischemia (CLTI) is often 
      associated with multilevel arterial disease, it usually requires 
      revascularization at different sites of the limb vasculature. We aim to assess 
      the outcome of the hybrid interventions including open surgical revascularization 
      together with outflow segment percutaneous transluminal angioplasty (PTA) in 
      patients with chronic limb-threatening ischemia. MATERIAL AND METHODS: This study 
      included all hybrid outflow-PTA interventions (n = 80) on patients suffering from 
      CLTI performed in Helsinki University Hospital between 2003 and 2015. Follow-up 
      ended on 31 December 2019. Patient data were prospectively collected into our 
      vascular registry and scrutinized retrospectively. Thirty-one patients (39%) 
      suffered from rest pain (Rutherford category IV) and 49 patients (61%) had 
      ischemic ulcers (Rutherford category V-VI). The most common open surgical 
      procedure was femoral endarterectomy (n = 63, 79%) and the most common 
      endovascular procedure was superficial femoral artery percutaneous transluminal 
      angioplasty (n = 65, 81%). Mean follow-up time was 56 months (range: 
      4 days-183 months). RESULTS: Limb salvage was at 30 days-92%, at 1 year-91%, and 
      at 5 and 10 years-86%. Survival and amputation-free survival were at 30 days-93% 
      and 86%, at 1 year-80% and 76%, at 5 years-51% and 48%, and at 10 years-21% and 
      21%. Wound healing at 3, 6, and 12 months was 48%, 71%, and 87%. Freedom from 
      target lesion revascularization was at 30 days-97%, at 1 year-88%, at 
      5 years-72%, and at 10 years-66%. CONCLUSION: Hybrid outflow revascularization is 
      an important tool in the vascular surgeon's armamentarium for treatment of 
      patients with multilevel arterial disease causing chronic limb-threatening 
      ischemia.
FAU - Serna Santos, J
AU  - Serna Santos J
AUID- ORCID: 0000-0003-4941-6667
AD  - Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
FAU - Soderstrom, M
AU  - Soderstrom M
AD  - Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
FAU - Helminen, R
AU  - Helminen R
AD  - Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
FAU - Aho, P
AU  - Aho P
AD  - Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
FAU - Halmesmaki, K
AU  - Halmesmaki K
AD  - Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
FAU - Venermo, M
AU  - Venermo M
AUID- ORCID: 0000-0001-8814-0988
AD  - Department of Vascular Surgery, Helsinki University Hospital, Helsinki, Finland.
LA  - eng
PT  - Journal Article
DEP - 20201213
PL  - England
TA  - Scand J Surg
JT  - Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical 
      Society and the Scandinavian Surgical Society
JID - 101144297
SB  - IM
MH  - Amputation, Surgical
MH  - Chronic Limb-Threatening Ischemia
MH  - *Endovascular Procedures
MH  - Humans
MH  - Ischemia/etiology/surgery
MH  - Limb Salvage
MH  - *Peripheral Arterial Disease/surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Vascular Patency
OTO - NOTNLM
OT  - Peripheral arterial disease
OT  - chronic limb-threatening ischemia
OT  - critical limb ischemia
OT  - hybrid
OT  - ischemic ulcer
OT  - ischemic wound
OT  - outflow
EDAT- 2020/12/15 06:00
MHDA- 2021/12/15 06:00
CRDT- 2020/12/14 09:50
PHST- 2020/12/15 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2020/12/14 09:50 [entrez]
AID - 10.1177/1457496920975608 [doi]
PST - ppublish
SO  - Scand J Surg. 2021 Jun;110(2):241-247. doi: 10.1177/1457496920975608. Epub 2020 
      Dec 13.