PMID- 33548420
OWN - NLM
STAT- MEDLINE
DCOM- 20210927
LR  - 20221207
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 74
IP  - 1
DP  - 2021 Jul
TI  - Revascularization of multiple tibial arteries is not associated with improved 
      limb salvage.
PG  - 170-177
LID - S0741-5214(21)00155-5 [pii]
LID - 10.1016/j.jvs.2021.01.026 [doi]
AB  - OBJECTIVE: We sought to determine the benefit of performing multiple tibial 
      artery revascularization compared with single vessel revascularization for 
      patients with chronic limb-threatening ischemia (CLTI). METHODS: We performed a 
      single-center, retrospective cohort study of all patients with CLTI treated with 
      below-the-knee endovascular intervention from 2012 to 2019. Group 1 included 
      patients who had undergone single tibial artery revascularization. Group 2 
      included patients who had undergone multiple (two or more) tibial artery 
      revascularization. More proximal disease, if present, was treated, in addition to 
      the tibial disease. The primary endpoint was freedom from amputation. The 
      secondary endpoints included the reintervention rates and all-cause mortality. 
      RESULTS: A total of 527 limbs in 470 patients with CLTI (nonhealing ulcers, 62%; 
      gangrene, 33%; and ischemic rest pain, 5%) were included in the present study. Of 
      the 527 limbs, 245 (46%) had undergone single vessel revascularization and 282 
      (54%) had undergone multiple vessel revascularization. The mean follow-up was 
      19 +/- 18 months. No difference was found in freedom from amputation between the 
      two groups (68% vs 63%; P = .109). On multivariable analysis, the factors 
      associated with amputation included dialysis (odds ratio [OR], 1.68; 95% 
      confidence interval [CI], 1.16-2.45), dyslipidemia (OR, 1.37; 95% CI, 0.96-1.94), 
      and gangrene (OR, 2.08; 95% CI, 1.50-2.98). No differences were found in the 
      reintervention rates between the two groups (21.2% vs 16.7%; P = .13). The 
      overall survival rate was 73% in both study groups. CONCLUSIONS: The results from 
      the present large, single-center study have demonstrated that multiple 
      below-the-knee vessel revascularization is not associated with improved limb 
      salvage compared with single vessel revascularization.
CI  - Copyright (c) 2021 Society for Vascular Surgery. Published by Elsevier Inc. All 
      rights reserved.
FAU - Hater, Haitam
AU  - Hater H
AD  - Department of Vascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Sackler 
      School of Medicine, Tel Aviv, Israel.
FAU - Halak, Moshe
AU  - Halak M
AD  - Department of Vascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Sackler 
      School of Medicine, Tel Aviv, Israel.
FAU - Sunoqrot, Hakam
AU  - Sunoqrot H
AD  - Department of Vascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Sackler 
      School of Medicine, Tel Aviv, Israel.
FAU - Khaitovich, Boris
AU  - Khaitovich B
AD  - Division of Interventional Radiology, Chaim Sheba Medical Center, Tel Hashomer, 
      Sackler School of Medicine, Tel Aviv, Israel.
FAU - Raskin, Daniel
AU  - Raskin D
AD  - Division of Interventional Radiology, Chaim Sheba Medical Center, Tel Hashomer, 
      Sackler School of Medicine, Tel Aviv, Israel.
FAU - Silverberg, Daniel
AU  - Silverberg D
AD  - Department of Vascular Surgery, Chaim Sheba Medical Center, Tel Hashomer, Sackler 
      School of Medicine, Tel Aviv, Israel. Electronic address: 
      daniel.silverberg@sheba.gov.il.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20210204
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
CIN - J Vasc Surg. 2021 Oct;74(4):1434-1435. PMID: 34598765
CIN - J Vasc Surg. 2021 Oct;74(4):1435. PMID: 34598766
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation, Surgical
MH  - *Angioplasty, Balloon/adverse effects/instrumentation
MH  - Chronic Disease
MH  - Databases, Factual
MH  - Female
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  - Progression-Free Survival
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Self Expandable Metallic Stents
MH  - *Tibial Arteries/diagnostic imaging/physiopathology
MH  - Time Factors
OTO - NOTNLM
OT  - Balloon angioplasty
OT  - Below the knee
OT  - Chronic limb-threatening ischemia
OT  - Endovascular revascularization
OT  - Peripheral arterial disease
OT  - Tibial angioplasty
EDAT- 2021/02/07 06:00
MHDA- 2021/09/28 06:00
CRDT- 2021/02/06 20:10
PHST- 2020/09/23 00:00 [received]
PHST- 2021/01/03 00:00 [accepted]
PHST- 2021/02/07 06:00 [pubmed]
PHST- 2021/09/28 06:00 [medline]
PHST- 2021/02/06 20:10 [entrez]
AID - S0741-5214(21)00155-5 [pii]
AID - 10.1016/j.jvs.2021.01.026 [doi]
PST - ppublish
SO  - J Vasc Surg. 2021 Jul;74(1):170-177. doi: 10.1016/j.jvs.2021.01.026. Epub 2021 
      Feb 4.