PMID- 34569374
OWN - NLM
STAT- MEDLINE
DCOM- 20220309
LR  - 20221207
IS  - 1477-0377 (Electronic)
IS  - 1358-863X (Linking)
VI  - 27
IP  - 1
DP  - 2022 Feb
TI  - Propensity-matched analysis does not support angiosome-guided revascularization 
      of multilevel peripheral artery disease (PAD).
PG  - 47-54
LID - 10.1177/1358863X211038627 [doi]
AB  - BACKGROUND: This retrospective comparative cohort study evaluated the clinical 
      outcome of angiosome-guided endovascular arterial reconstructions in chronic 
      limb-threatening ischemia (CLTI) due to multilevel peripheral artery disease 
      (PAD). METHODS: Patients treated in an endovascular fashion for CLTI with tissue 
      loss due to multilevel PAD were analyzed. Limbs were classified as having 
      undergone either angiosome-guided (direct) revascularization (DR) or 
      nonangiosomic (indirect) revascularization (IR). DR was defined as uninterrupted 
      in-line flow to the affected angiosome, revascularization through the pedal arch 
      was also considered direct. Groups were adjusted with propensity score (PS) 
      matching and compared for amputation-free survival (AFS), freedom from major 
      adverse limb events (MALE), and healing rate at 12 months. RESULTS: A total of 
      174 patients (81 men, mean age 70.0 +/- 10.4 y) were included. PS matching produced 
      two groups of 55 patients each: DR (24 men, mean age 71.7 +/- 10.7 y) and IR (26 
      men, mean age 72.0 +/- 9.4 y). The matched groups had no significant differences in 
      baseline variables. At 12 months there were no significant differences in AFS 
      (73.2% vs 71.6%; p = 0.841), freedom from MALE (71.7% vs 66.1%; p = 0.617), and 
      healing rate (72.7% vs 72.0%; p = 1.000) between DR and IR, respectively. 
      CONCLUSION: This study failed to support the use of angiosome concept in CLTI due 
      to multilevel disease.
FAU - Kurianov, Pavel
AU  - Kurianov P
AUID- ORCID: 0000-0001-5844-2547
AD  - Center on Diabetic Foot and Surgical Infection, St George's Hospital, Saint 
      Petersburg, Russia.
FAU - Lipin, Alexandr
AU  - Lipin A
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Antropov, Alexey
AU  - Antropov A
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Atmadzas, Kirill
AU  - Atmadzas K
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Gruzdev, Nikita
AU  - Gruzdev N
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Tankaeva, Zaynab
AU  - Tankaeva Z
AD  - Almazov National Medical Research Centre, Saint Petersburg, Russia.
FAU - Atmadzas, Alisa
AU  - Atmadzas A
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Orlov, Anton
AU  - Orlov A
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Borisov, Alexey
AU  - Borisov A
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Sobolev, Roman
AU  - Sobolev R
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
FAU - Eminov, Yanis
AU  - Eminov Y
AD  - Limb Salvage Center, Hospital #14, Saint Petersburg, Russia.
LA  - eng
PT  - Journal Article
DEP - 20210926
PL  - England
TA  - Vasc Med
JT  - Vascular medicine (London, England)
JID - 9610930
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation, Surgical
MH  - Cohort Studies
MH  - Humans
MH  - Ischemia/diagnostic imaging/surgery
MH  - *Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - *Peripheral Arterial Disease/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *angiosome
OT  - *critical limb ischemia (CLI)
OT  - *endovascular therapy
OT  - *peripheral artery disease (PAD)
EDAT- 2021/09/28 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/09/27 08:47
PHST- 2021/09/28 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/09/27 08:47 [entrez]
AID - 10.1177/1358863X211038627 [doi]
PST - ppublish
SO  - Vasc Med. 2022 Feb;27(1):47-54. doi: 10.1177/1358863X211038627. Epub 2021 Sep 26.