PMID- 36042581
OWN - NLM
STAT- MEDLINE
DCOM- 20240205
LR  - 20240206
IS  - 1708-539X (Electronic)
IS  - 1708-5381 (Linking)
VI  - 32
IP  - 1
DP  - 2024 Feb
TI  - Predictors of infrapopliteal vein bypass graft revision in patients with chronic 
      limb-threatening ischemia.
PG  - 65-75
LID - 10.1177/17085381221124706 [doi]
AB  - PURPOSE: Surgical revascularization is the standard treatment for chronic 
      limb-threatening ischemia (CLTI). However, some patients may require 
      reintervention. The Global Anatomic Staging System (GLASS), which evaluates the 
      complexity of infrainguinal lesions, was proposed. This study aimed to identify 
      predictors for graft revision and evaluate whether GLASS impacts vein graft 
      revision. METHODS: Between 2011 and 2018, CLTI patients who underwent de novo 
      infrapopliteal bypass using autogenous veins were retrospectively analyzed. To 
      assess anatomic complexity with GLASS, femoropopliteal, infrapopliteal, and 
      inframalleolar/pedal (IM) disease grades were determined. The outcomes of 
      patients with or without graft revision were compared. Cox regression analysis 
      was performed. RESULTS: Thirty-six of the 80 patients underwent reintervention 
      for graft revision. Compared to the non-graft revision group, the graft revision 
      group exhibited significantly higher rates of GLASS stage III (66% vs 81%, p = 
      0.046) and grade P2 IM disease (25% vs 58%, p = 0.009). Multivariate analysis 
      revealed that IM grade P2 (hazard ratio [HR], 3.35; 95% confidence interval [CI], 
      1.66-6.75; p = 0.001) and spliced vein grafts (HR, 3.18; 95% CI, 1.43-7.06; p = 
      0.005) were significantly associated with graft revision. CONCLUSIONS: This study 
      demonstrated that IM grade P2 and spliced vein grafts were predictors of graft 
      revision. The GLASS stratification of IM disease grade may be useful in 
      optimizing treatment for CLTI.
FAU - Kawai, Yohei
AU  - Kawai Y
AUID- ORCID: 0000-0002-7030-1541
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Kodama, Akio
AU  - Kodama A
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Sato, Tomohiro
AU  - Sato T
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Ikeda, Shuta
AU  - Ikeda S
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Tsuruoka, Takuya
AU  - Tsuruoka T
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Sugimoto, Masayuki
AU  - Sugimoto M
AUID- ORCID: 0000-0002-1712-4398
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Niimi, Kiyoaki
AU  - Niimi K
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Banno, Hiroshi
AU  - Banno H
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
FAU - Komori, Kimihiro
AU  - Komori K
AD  - Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan. RINGGOLD: 36589
LA  - eng
PT  - Journal Article
DEP - 20220830
PL  - England
TA  - Vascular
JT  - Vascular
JID - 101196722
SB  - IM
MH  - Humans
MH  - Chronic Limb-Threatening Ischemia
MH  - Retrospective Studies
MH  - Vascular Patency
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Ischemia/diagnostic imaging/surgery
MH  - *Peripheral Arterial Disease/diagnostic imaging/surgery
MH  - Limb Salvage
MH  - *Endovascular Procedures/adverse effects
MH  - Chronic Disease
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - distal bypass
OT  - global anatomic staging system
OT  - graft revision
COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2022/09/01 06:00
MHDA- 2024/02/05 06:44
CRDT- 2022/08/31 01:02
PHST- 2024/02/05 06:44 [medline]
PHST- 2022/09/01 06:00 [pubmed]
PHST- 2022/08/31 01:02 [entrez]
AID - 10.1177/17085381221124706 [doi]
PST - ppublish
SO  - Vascular. 2024 Feb;32(1):65-75. doi: 10.1177/17085381221124706. Epub 2022 Aug 30.