Comparison of clinical outcome after bypass surgery vs. endovascular therapy for infrainguinal artery disease in patients with critical limb ischemia
| Autor: | Yoshimitsu Soga, Shinsuke Mii, Hideaki Aihara, Jin Okazaki, Sosei Kuma, Terutoshi Yamaoka, Daisuke Kamoi, Yoshiaki Shintani, Toshinobu Ishikawa, null on behalf of ReCANALISE Investigators |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Disease Endovascular therapy Amputation Surgical Disease-Free Survival Ischemia medicine Humans Registries Adverse effect Aged Retrospective Studies Aged 80 and over business.industry Hazard ratio Extremities General Medicine Critical limb ischemia Middle Aged Confidence interval Surgery body regions Survival Rate medicine.anatomical_structure Bypass surgery Female medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 77(8) |
| ISSN: | 1347-4820 |
| Popis: | Background The efficacy of stent-assisted endovascular therapy (EVT) in patients with critical limb ischemia (CLI) compared to bypass surgery (BSX) remains unclear. Methods and results This study was performed as a multicenter retrospective registry. Between January 2004 and December 2009, 460 CLI patients (460 first treated limbs) who underwent BSX (237 patients) or EVT (223 patients) for de novo infrainguinal lesions were identified retrospectively and analyzed. The main endpoints of this study were amputation-free survival (AFS), overall survival, limb salvage rate and freedom from major adverse limb events (MALE; includes any repeat revascularization and major amputation). Three-year AFS, limb salvage rate and overall survival were not different between the BSX and EVT groups (60.3% vs. 58.0%, P=0.43; 85.1% vs. 84.2%, P=0.91; 67.2% vs. 69.8%, P=0.96, respectively), but freedom from MALE was significantly lower in the EVT group during follow-up (69.1% vs. 51.1%, P=0.002). After adjusting endpoints with covariates, there was also no significant difference in AFS, limb salvage, and overall survival between EVT and BSX. Freedom from MALE, however, was still significantly lower in the EVT group (hazard ratio, 0.66; 95% confidence interval: 0.47-0.92, adjusted P=0.01). Conclusions Serious adverse events with the exception of MALE after EVT seem to be acceptable compared to that after BSX in patients with CLI due to infrainguinal disease. |
| Databáze: | OpenAIRE |
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