Outcomes of Infrainguinal Revascularizations with Endovascular First Strategy in Critical Limb Ischemia

Purpose This study was designed to study the outcome of infrainguinal revascularization in patients with critical limb ischemia (CLI) in an institution with a preference towards endovascular intervention first in patients with poor condition, unfavourable anatomy for surgery, no venous material for...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2015-06, Vol.38 (3), p.552-559
Main Authors: Jens, Sjoerd, Conijn, Anne P., Frans, Franceline A., Nieuwenhuis, Marieke B. B., Met, Rosemarie, Koelemay, Mark J. W., Legemate, Dink A., Bipat, Shandra, Reekers, Jim A.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Amputation - statistics & numerical data
ANATOMY
Angioplasty, Balloon
BYPASSES
Cardiology
Clinical Investigation
Cohort Studies
COMPARATIVE EVALUATIONS
Disease-Free Survival
Female
Follow-Up Studies
Humans
Imaging
ISCHEMIA
Ischemia - physiopathology
Ischemia - surgery
Ischemia - therapy
LIMBS
Lower Extremity - blood supply
Lower Extremity - physiopathology
Lower Extremity - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
PATIENTS
Prospective Studies
Quality of Life
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
Risk Factors
SURGERY
Surveys and Questionnaires
Treatment Outcome
Ultrasound
Vascular Patency - physiology
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Summary:Purpose This study was designed to study the outcome of infrainguinal revascularization in patients with critical limb ischemia (CLI) in an institution with a preference towards endovascular intervention first in patients with poor condition, unfavourable anatomy for surgery, no venous material for bypass, and old age. Methods A prospective, observational cohort study was conducted between May 2007 and May 2010 in patients presenting with CLI. At baseline, the optimal treatment was selected, i.e., endovascular or surgical treatment. In case of uncertainty about the preferred treatment, a multidisciplinary team (MDT) was consulted. Primary endpoints were quality of life and functional status 6 and 12 months after initial intervention, assessed by the VascuQol and AMC Linear Disability Score questionnaires, respectively. Results In total, 113 patients were included; 86 had an endovascular intervention and 27 had surgery. During follow-up, 41 % underwent an additional ipsilateral revascularisation procedure. For the total population, and endovascular and surgery subgroups, the VascuQol sum scores improved after 6 and 12 months ( p  
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-014-0955-5