PMID- 35738475
OWN - NLM
STAT- MEDLINE
DCOM- 20221025
LR  - 20221204
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 76
IP  - 5
DP  - 2022 Nov
TI  - Evaluation of global limb anatomic staging system for patients with chronic 
      limb-threatening ischemia treated with autogenous bypass grafts.
PG  - 1347-1353.e2
LID - S0741-5214(22)01729-3 [pii]
LID - 10.1016/j.jvs.2022.06.008 [doi]
AB  - OBJECTIVE: We evaluated the relationship of the global limb anatomic staging 
      system (GLASS) stage with the clinical outcomes for patients with chronic 
      limb-threatening ischemia (CLTI) who had undergone distal bypass with vein 
      grafting. METHODS: We performed a single-center, retrospective analysis of 
      patients with CLTI who had undergone distal bypass with vein grafting from 
      January 2012 to December 2019. The primary end point was freedom from CLTI, 
      including amputation-free survival, complete wound healing, and no ischemic rest 
      pain. The secondary end points included a composite outcome of recurrence 
      (patients who had achieved freedom from CLTI but had developed a new wound or 
      ischemic rest pain), major limb amputation, amputation free-survival, overall 
      survival, major adverse limb events, limb-based patency, and primary and 
      secondary patency rates. RESULTS: A total of 190 patients had undergone 211 
      distal bypasses with a median follow-up of 30 months. Of these patients, 80% had 
      had diabetes or end-stage renal disease requiring dialysis. Most patients (63%) 
      had experienced major or extensive tissue loss (WIfI [wound, ischemia, foot 
      infection] wound class >/=2), and more than one half of these had had some degree 
      of infection of the foot. A severe anatomic pattern (GLASS stage III) was 
      predominant, with a prevalence of 78%. No significant differences were found 
      between GLASS stage I and II and GLASS stage III groups for all the outcomes 
      analyzed. Approximately 80% of the 211 revascularized limbs were free of CLTI at 
      12 months after treatment. At 4 years of follow-up, we observed that 25% of the 
      patients had had CLTI recurrence, 83% were free from major amputation, and 61% 
      were free from major adverse limb events. Limb-based patency, primary patency, 
      and secondary patency were 79%, 80%, and 93% at 1 year and 64%, 65%, and 81% at 
      4 years, respectively. CONCLUSIONS: The GLASS stage was not related to patency or 
      the clinical outcomes after distal bypass with vein grafting. Distal open 
      revascularization resulted in excellent rates of freedom from CLTI with low rates 
      of CLTI recurrence, two key time-integrated outcomes of clinical disease severity 
      for patients with CLTI.
CI  - Copyright (c) 2022 Society for Vascular Surgery. Published by Elsevier Inc. All 
      rights reserved.
FAU - Soares, Tony R
AU  - Soares TR
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal. Electronic address: tony.ramos.soares@gmail.com.
FAU - Cabral, Goncalo
AU  - Cabral G
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal.
FAU - Costa, Tiago
AU  - Costa T
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal.
FAU - Tiago, Jose
AU  - Tiago J
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal.
FAU - Gimenez, Jose
AU  - Gimenez J
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal.
FAU - Duarte, Armanda
AU  - Duarte A
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal.
FAU - Cunha E Sa, Diogo
AU  - Cunha E Sa D
AD  - Department of Angiology and Vascular Surgery, Hospital Beatriz Angelo, Loures, 
      Portugal.
LA  - eng
PT  - Journal Article
DEP - 20220621
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Humans
MH  - Limb Salvage/methods
MH  - *Peripheral Arterial Disease
MH  - *Endovascular Procedures/adverse effects
MH  - Chronic Limb-Threatening Ischemia
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Risk Factors
MH  - Time Factors
MH  - Ischemia/diagnostic imaging/surgery
MH  - Pain/etiology
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - GLASS
OT  - Infrapopliteal disease
OT  - Open revascularization
OT  - Tibioperoneal disease
EDAT- 2022/06/24 06:00
MHDA- 2022/10/26 06:00
CRDT- 2022/06/23 19:24
PHST- 2022/03/12 00:00 [received]
PHST- 2022/05/31 00:00 [revised]
PHST- 2022/06/11 00:00 [accepted]
PHST- 2022/06/24 06:00 [pubmed]
PHST- 2022/10/26 06:00 [medline]
PHST- 2022/06/23 19:24 [entrez]
AID - S0741-5214(22)01729-3 [pii]
AID - 10.1016/j.jvs.2022.06.008 [doi]
PST - ppublish
SO  - J Vasc Surg. 2022 Nov;76(5):1347-1353.e2. doi: 10.1016/j.jvs.2022.06.008. Epub 
      2022 Jun 21.