PMID- 33407009
OWN - NLM
STAT- MEDLINE
DCOM- 20220309
LR  - 20221207
IS  - 1477-0377 (Electronic)
IS  - 1358-863X (Linking)
VI  - 26
IP  - 2
DP  - 2021 Apr
TI  - Inframalleolar bypass for chronic limb-threatening ischemia.
PG  - 187-194
LID - 10.1177/1358863X20978468 [doi]
AB  - The aims of this study were to analyze the results of inframalleolar bypass for 
      chronic limb-threatening ischemia (CLTI) and to identify outcome-predicting 
      factors. All consecutive patients undergoing inframalleolar bypass for CLTI 
      between 2015 and 2018 were included in this retrospective, single-center study. 
      Outflow artery was the most proximal patent vessel segment in continuity with 
      inframalleolar arteries. Bypasses originating from the popliteal artery were 
      defined as 'short bypasses'. Sixty patients underwent inframalleolar bypass, with 
      four patients undergoing bilateral procedures, making a total of 64 limbs 
      included. The mean age was 73 +/- 14 and 52 (81%) were male. The great saphenous 
      vein was the preferred conduit (n = 58, 91%), in a devalvulated fashion (n = 56, 
      88%). Superficial femoral artery was the most common inflow artery for 'long' 
      grafts (n = 22, 34%), while popliteal artery was the inflow artery for all 
      'short' grafts (n = 25, 39%). Dorsalis pedis artery was chosen as an outflow 
      artery in 41 patients (63%). Median follow-up was 21 months. Two-year primary and 
      secondary patency, limb salvage, amputation-free survival, and overall survival 
      rates were 67 +/- 6%, 88 +/- 4%, 84 +/- 4%, 72 +/- 6%, and 85 +/- 4%, respectively. At 
      multivariate analysis, dialysis was an independent predictor for poor primary 
      patency (HR, 4.6; 95% CI, 1.62-13.05; p = 0.004), whereas a short bypass was 
      independently associated with an increased primary patency (HR, 0.3; 95% CI, 
      0.10-0.89; p = 0.03). In conclusion, bypass grafting to the inframalleolar 
      arteries resulted in good patency rates, limb salvage and overall survival. 
      Dialysis patients had lower primary patency but still had good limb salvage and 
      survival. Short bypass was a predictor of improved primary patency.
FAU - Benedetto, Filippo
AU  - Benedetto F
AD  - Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and 
      Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, 
      Italy.
FAU - Spinelli, Domenico
AU  - Spinelli D
AUID- ORCID: 0000-0002-5002-0435
AD  - Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and 
      Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, 
      Italy.
FAU - Pipito, Narayana
AU  - Pipito N
AD  - Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and 
      Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, 
      Italy.
FAU - Barilla, David
AU  - Barilla D
AUID- ORCID: 0000-0002-4675-7901
AD  - Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and 
      Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, 
      Italy.
FAU - Stilo, Francesco
AU  - Stilo F
AD  - Vascular Surgery Unit, Campus Bio-Medico of Rome University, Rome, Italy.
FAU - De Caridi, Giovanni
AU  - De Caridi G
AD  - Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and 
      Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, 
      Italy.
FAU - Barilla, Chiara
AU  - Barilla C
AD  - Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and 
      Morphofunctional Imaging, Policlinico G. Martino, University of Messina, Messina, 
      Italy.
FAU - Spinelli, Francesco
AU  - Spinelli F
AD  - Vascular Surgery Unit, Campus Bio-Medico of Rome University, Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210106
PL  - England
TA  - Vasc Med
JT  - Vascular medicine (London, England)
JID - 9610930
SB  - IM
MH  - Amputation, Surgical
MH  - *Chronic Limb-Threatening Ischemia
MH  - Humans
MH  - *Ischemia/diagnostic imaging/surgery
MH  - Limb Salvage
MH  - Male
MH  - Popliteal Artery/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - Saphenous Vein
MH  - Treatment Outcome
MH  - Vascular Patency
OTO - NOTNLM
OT  - below-the-ankle bypass
OT  - chronic limb-threatening ischemia (CLTI)
OT  - infrainguinal bypass
OT  - inframalleolar bypass
OT  - lower limb revascularization
OT  - pedal artery
EDAT- 2021/01/08 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/01/07 05:41
PHST- 2021/01/08 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/01/07 05:41 [entrez]
AID - 10.1177/1358863X20978468 [doi]
PST - ppublish
SO  - Vasc Med. 2021 Apr;26(2):187-194. doi: 10.1177/1358863X20978468. Epub 2021 Jan 6.