Does the Global Limb Anatomic Staging System Inframalleolar Modifier Influence Long Term Outcomes of Chronic Limb Threatening Ischaemia after Distal Bypass?
| Autor: | Shinya Takahashi, Takanobu Okazaki, Masaki Hamamoto, Misa Hasegawa, Taira Kobayashi |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Ischemia Risk Assessment Amputation Surgical Lesion Peripheral Arterial Disease Predictive Value of Tests Risk Factors medicine Clinical endpoint Long term outcomes Humans Saphenous Vein Vascular Patency Aged Retrospective Studies Aged 80 and over Wound Healing medicine.diagnostic_test business.industry Angiography Middle Aged Limb Salvage medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Chronic Disease Distal bypass Female Vascular Grafting medicine.symptom Ankle Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. 62:590-596 |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/j.ejvs.2021.07.010 |
| Popis: | The purpose of this study was to evaluate the influence of inframalleolar disease (Global Limb Anatomic Staging System Inframalleolar [GLASS IM] modifier) on long term outcomes of patients with chronic limb threatening ischaemia (CLTI) after distal bypass.Patients who underwent distal bypass for CLTI from January 2012 to December 2019 at a single centre were reviewed retrospectively. Comparisons including baseline characteristics, procedural details, and long term outcomes were made between patients with an intact pedal arch (GLASS IM modifier P0), an absent or severely diseased pedal arch (P1), and no target artery crossing the ankle into the foot (P2), diagnosed by pre- and intra-operative high quality angiography. The primary endpoint was limb salvage. The secondary endpoints were graft patency and wound healing.A total of 254 distal bypasses were performed in 206 patients (139 males; median age, 76 years). The GLASS IM modifier was P0 in 80 (32%) limbs, P1 in 127 (50%), and P2 in 47 (18%). During the follow up period, 22 limbs (9%) required major amputation. The limb salvage rates at three years in P0, P1, and P2 cases were 94%, 89%, and 93%, respectively, with no significant differences among the modifiers. The primary patencies at three years in P0, P1, and P2 cases were 49%, 38% and 24%, respectively. The primary patency in P2 cases was significantly lower than that in P0 cases (p.050). The respective wound healing rates at 12 months were 97%, 93%, and 79%, and again the wound healing rate in P2 cases was significantly lower than those in other cases (p.050).Long term outcomes including patency, limb salvage, and wound healing after distal bypass for CLTI patients with an infrapopliteal lesion were acceptable in cases in each GLASS IM modifier. |
| Databáze: | OpenAIRE |
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