Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry

Nicola Troisi; Daniele Adami; Stefano Michelagnoli; Raffaella Berchiolli; Federico Accrocca; Alessio Amico; Andrea Angelini; Luca Arnuzzo; Andrea Ascoli Marchetti; Luca Attisani; Gennaro Bafile; Giuseppe Baldino; Enrico Barbanti; Stefano Bartoli; Raffaello Bellosta; Filippo Benedetto; Raoul Borioni; Franco Briolini; Cristina Busoni; Stefano Camparini; Pierluigi Cappiello; Luciano Carbonari; Francesco Casella; Giovanni Celoria; Andrea Chiama; Emiliano Chisci; Efrem Civilini; Francesco Alberto Codispoti; Barbara Conti; Giovanni Coppi; Giovanni De Blasis; Marcello D'Elia; Rossella Di Domenico; Carla Di Girolamo; Leonardo Ercolini; Alessandra Ferrari; Mauro Ferrari; Enzo Forliti; Paolo Frigatti; Dalmazio Frigerio; Pierfrancesco Frosini; Luca Garriboli; Antonio Nicola Giordano; Walter Guerrieri; Antonio Jannello; Mafalda Massara; Maurizio Merlo; Roberto Mezzetti; Tommaso Miccoli; Domenico Milite; Pietro Mingazzini; Marina Muncinelli; Giovanni Nano; Marco Natola; Claudio Novali; Giancarlo Palasciano; Reinhold Perkmann; Federica Persi; David Petruccelli; Mauro Pinelli; Giorgio Poletto; Carla Porta; Carlo Pratesi; Gianguido Pruner; Giovanni Ragazzi; Paolo Righini; Mauro Salvini; Paolo Scovazzi; Carlo Setacci; Alberto Maria Settembrini; Andrea Siani; Roberto Silingardi; Antonino Silvestro; Francesco Talarico; Valerio Tolva; Antonio Trani; Santi Trimarchi; Yamume Tshomba; Gennaro Vigliotti; Daniela Viola; Pietro Volpe; Federico Zani

doi:10.1016/j.ejvs.2022.06.004

Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry

Nicola Troisi, Daniele Adami, Stefano Michelagnoli, Raffaella Berchiolli, Federico Accrocca, Alessio Amico, Andrea Angelini, Luca Arnuzzo, Andrea Ascoli Marchetti, Luca Attisani, Gennaro Bafile, Giuseppe Baldino, Enrico Barbanti, Stefano Bartoli, Raffaello Bellosta, Filippo Benedetto, Raoul Borioni, Franco Briolini, Cristina Busoni, Stefano CampariniPierluigi Cappiello, Luciano Carbonari, Francesco Casella, Giovanni Celoria, Andrea Chiama, Emiliano Chisci, Efrem Civilini, Francesco Alberto Codispoti, Barbara Conti, Giovanni Coppi, Giovanni De Blasis, Marcello D'Elia, Rossella Di Domenico, Carla Di Girolamo, Leonardo Ercolini, Alessandra Ferrari, Mauro Ferrari, Enzo Forliti, Paolo Frigatti, Dalmazio Frigerio, Pierfrancesco Frosini, Luca Garriboli, Antonio Nicola Giordano, Walter Guerrieri, Antonio Jannello, Mafalda Massara, Maurizio Merlo, Roberto Mezzetti, Tommaso Miccoli, Domenico Milite, Pietro Mingazzini, Marina Muncinelli, Giovanni Nano, Marco Natola, Claudio Novali, Giancarlo Palasciano, Reinhold Perkmann, Federica Persi, David Petruccelli, Mauro Pinelli, Giorgio Poletto, Carla Porta, Carlo Pratesi, Gianguido Pruner, Giovanni Ragazzi, Paolo Righini, Mauro Salvini, Paolo Scovazzi, Carlo Setacci, Alberto Maria Settembrini, Andrea Siani, Roberto Silingardi, Antonino Silvestro, Francesco Talarico, Valerio Tolva, Antonio Trani, Santi Trimarchi, Yamume Tshomba, Gennaro Vigliotti, Daniela Viola, Pietro Volpe, Federico Zani

Research output: Contribution to journal › Article

Abstract

Objective: The aim was to demonstrate contemporary outcomes of in situ saphenous vein bypass using a valvulotome.Methods: Analysis of two year outcomes of a multicentre registry based on the treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique (LIMBSAVE). Between January 2018 and December 2019, 541 patients in 43 centres were enrolled. In all patients an innovative valvulotome was used. Early outcomes were assessed. Two year outcomes according to KaplaneMeier curves in terms of patency and limb salvage were evaluated. Associations between patient and procedure variables were analysed with univariable and multivariable analyses.Results: In all cases, a valvulotome was able to lyse the valves. Vein injury due to the in situ technique was 3.5%. Thirty day mortality and major amputation rates were 3% and 0.9%, respectively. Mean follow up was 12.1 months. Two year estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 69.1%, 81.4%, 86.5%, and 94.5%, respectively. Multivariable analysis showed an association between pre-operative vein diameter < 3 mm and lower primary patency (hazard ration [HR] 14.3, p <.001), primary assisted patency (HR 9.4, p = .002), secondary patency (HR 7.2, p =. 07), and limb salvage (HR 7.8, p = .005) rates. Distal anastomosis to a tibial or foot vessel was also associated with lower primary patency (HR 4.8, p = .033), and primary assisted patency (HR 6, p = .011) rates. Use of a suprafascial tributary collateral as a graft was associated with lower primary patency (HR 6.7, p = .013), and primary assisted patency (HR 4.2, p = .042) rates.Conclusion: Vein diameter < 3 mm, distal anastomosis on a tibial or foot vessel, and use of a suprafascial tributary collateral as a graft were significantly associated with loss of patency and limb loss during follow up.

Original language	English
Pages (from-to)	350-358
Number of pages	9
Journal	European Journal of Vascular and Endovascular Surgery
Volume	64
DOIs	https://doi.org/10.1016/j.ejvs.2022.06.004
Publication status	Published - 2022

Keywords

Critical limb threatening ischaemia
Peripheral bypass
Limb salvage
In situ saphenous vein

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Troisi, N., Adami, D., Michelagnoli, S., Berchiolli, R., Accrocca, F., Amico, A., Angelini, A., Arnuzzo, L., Marchetti, A. A., Attisani, L., Bafile, G., Baldino, G., Barbanti, E., Bartoli, S., Bellosta, R., Benedetto, F., Borioni, R., Briolini, F., Busoni, C., ... Zani, F. (2022). Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry. European Journal of Vascular and Endovascular Surgery, 64, 350-358. https://doi.org/10.1016/j.ejvs.2022.06.004

@article{6ae483c150a84a959dad48f468404664,

title = "Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry",

abstract = "Objective: The aim was to demonstrate contemporary outcomes of in situ saphenous vein bypass using a valvulotome.Methods: Analysis of two year outcomes of a multicentre registry based on the treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique (LIMBSAVE). Between January 2018 and December 2019, 541 patients in 43 centres were enrolled. In all patients an innovative valvulotome was used. Early outcomes were assessed. Two year outcomes according to KaplaneMeier curves in terms of patency and limb salvage were evaluated. Associations between patient and procedure variables were analysed with univariable and multivariable analyses.Results: In all cases, a valvulotome was able to lyse the valves. Vein injury due to the in situ technique was 3.5%. Thirty day mortality and major amputation rates were 3% and 0.9%, respectively. Mean follow up was 12.1 months. Two year estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 69.1%, 81.4%, 86.5%, and 94.5%, respectively. Multivariable analysis showed an association between pre-operative vein diameter < 3 mm and lower primary patency (hazard ration [HR] 14.3, p <.001), primary assisted patency (HR 9.4, p = .002), secondary patency (HR 7.2, p =. 07), and limb salvage (HR 7.8, p = .005) rates. Distal anastomosis to a tibial or foot vessel was also associated with lower primary patency (HR 4.8, p = .033), and primary assisted patency (HR 6, p = .011) rates. Use of a suprafascial tributary collateral as a graft was associated with lower primary patency (HR 6.7, p = .013), and primary assisted patency (HR 4.2, p = .042) rates.Conclusion: Vein diameter < 3 mm, distal anastomosis on a tibial or foot vessel, and use of a suprafascial tributary collateral as a graft were significantly associated with loss of patency and limb loss during follow up.",

keywords = "Critical limb threatening ischaemia, Peripheral bypass, Limb salvage, In situ saphenous vein, Critical limb threatening ischaemia, Peripheral bypass, Limb salvage, In situ saphenous vein",

author = "Nicola Troisi and Daniele Adami and Stefano Michelagnoli and Raffaella Berchiolli and Federico Accrocca and Alessio Amico and Andrea Angelini and Luca Arnuzzo and Marchetti, {Andrea Ascoli} and Luca Attisani and Gennaro Bafile and Giuseppe Baldino and Enrico Barbanti and Stefano Bartoli and Raffaello Bellosta and Filippo Benedetto and Raoul Borioni and Franco Briolini and Cristina Busoni and Stefano Camparini and Pierluigi Cappiello and Luciano Carbonari and Francesco Casella and Giovanni Celoria and Andrea Chiama and Emiliano Chisci and Efrem Civilini and Codispoti, {Francesco Alberto} and Barbara Conti and Giovanni Coppi and {De Blasis}, Giovanni and Marcello D'Elia and {Di Domenico}, Rossella and {Di Girolamo}, Carla and Leonardo Ercolini and Alessandra Ferrari and Mauro Ferrari and Enzo Forliti and Paolo Frigatti and Dalmazio Frigerio and Pierfrancesco Frosini and Luca Garriboli and Giordano, {Antonio Nicola} and Walter Guerrieri and Antonio Jannello and Mafalda Massara and Maurizio Merlo and Roberto Mezzetti and Tommaso Miccoli and Domenico Milite and Pietro Mingazzini and Marina Muncinelli and Giovanni Nano and Marco Natola and Claudio Novali and Giancarlo Palasciano and Reinhold Perkmann and Federica Persi and David Petruccelli and Mauro Pinelli and Giorgio Poletto and Carla Porta and Carlo Pratesi and Gianguido Pruner and Giovanni Ragazzi and Paolo Righini and Mauro Salvini and Paolo Scovazzi and Carlo Setacci and Settembrini, {Alberto Maria} and Andrea Siani and Roberto Silingardi and Antonino Silvestro and Francesco Talarico and Valerio Tolva and Antonio Trani and Santi Trimarchi and Yamume Tshomba and Gennaro Vigliotti and Daniela Viola and Pietro Volpe and Federico Zani",

year = "2022",

doi = "10.1016/j.ejvs.2022.06.004",

language = "English",

volume = "64",

pages = "350--358",

journal = "European Journal of Vascular and Endovascular Surgery",

issn = "1078-5884",

publisher = "W.B. Saunders Ltd",

}

Troisi, N, Adami, D, Michelagnoli, S, Berchiolli, R, Accrocca, F, Amico, A, Angelini, A, Arnuzzo, L, Marchetti, AA, Attisani, L, Bafile, G, Baldino, G, Barbanti, E, Bartoli, S, Bellosta, R, Benedetto, F, Borioni, R, Briolini, F, Busoni, C, Camparini, S, Cappiello, P, Carbonari, L, Casella, F, Celoria, G, Chiama, A, Chisci, E, Civilini, E, Codispoti, FA, Conti, B, Coppi, G, De Blasis, G, D'Elia, M, Di Domenico, R, Di Girolamo, C, Ercolini, L, Ferrari, A, Ferrari, M, Forliti, E, Frigatti, P, Frigerio, D, Frosini, P, Garriboli, L, Giordano, AN, Guerrieri, W, Jannello, A, Massara, M, Merlo, M, Mezzetti, R, Miccoli, T, Milite, D, Mingazzini, P, Muncinelli, M, Nano, G, Natola, M, Novali, C, Palasciano, G, Perkmann, R, Persi, F, Petruccelli, D, Pinelli, M, Poletto, G, Porta, C, Pratesi, C, Pruner, G, Ragazzi, G, Righini, P, Salvini, M, Scovazzi, P, Setacci, C, Settembrini, AM, Siani, A, Silingardi, R, Silvestro, A, Talarico, F, Tolva, V, Trani, A, Trimarchi, S, Tshomba, Y, Vigliotti, G, Viola, D, Volpe, P & Zani, F 2022, 'Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry', European Journal of Vascular and Endovascular Surgery, vol. 64, pp. 350-358. https://doi.org/10.1016/j.ejvs.2022.06.004

Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry. / Troisi, Nicola; Adami, Daniele; Michelagnoli, Stefano et al.
In: European Journal of Vascular and Endovascular Surgery, Vol. 64, 2022, p. 350-358.

Research output: Contribution to journal › Article

TY - JOUR

T1 - Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry

AU - Troisi, Nicola

AU - Adami, Daniele

AU - Michelagnoli, Stefano

AU - Berchiolli, Raffaella

AU - Accrocca, Federico

AU - Amico, Alessio

AU - Angelini, Andrea

AU - Arnuzzo, Luca

AU - Marchetti, Andrea Ascoli

AU - Attisani, Luca

AU - Bafile, Gennaro

AU - Baldino, Giuseppe

AU - Barbanti, Enrico

AU - Bartoli, Stefano

AU - Bellosta, Raffaello

AU - Benedetto, Filippo

AU - Borioni, Raoul

AU - Briolini, Franco

AU - Busoni, Cristina

AU - Camparini, Stefano

AU - Cappiello, Pierluigi

AU - Carbonari, Luciano

AU - Casella, Francesco

AU - Celoria, Giovanni

AU - Chiama, Andrea

AU - Chisci, Emiliano

AU - Civilini, Efrem

AU - Codispoti, Francesco Alberto

AU - Conti, Barbara

AU - Coppi, Giovanni

AU - De Blasis, Giovanni

AU - D'Elia, Marcello

AU - Di Domenico, Rossella

AU - Di Girolamo, Carla

AU - Ercolini, Leonardo

AU - Ferrari, Alessandra

AU - Ferrari, Mauro

AU - Forliti, Enzo

AU - Frigatti, Paolo

AU - Frigerio, Dalmazio

AU - Frosini, Pierfrancesco

AU - Garriboli, Luca

AU - Giordano, Antonio Nicola

AU - Guerrieri, Walter

AU - Jannello, Antonio

AU - Massara, Mafalda

AU - Merlo, Maurizio

AU - Mezzetti, Roberto

AU - Miccoli, Tommaso

AU - Milite, Domenico

AU - Mingazzini, Pietro

AU - Muncinelli, Marina

AU - Nano, Giovanni

AU - Natola, Marco

AU - Novali, Claudio

AU - Palasciano, Giancarlo

AU - Perkmann, Reinhold

AU - Persi, Federica

AU - Petruccelli, David

AU - Pinelli, Mauro

AU - Poletto, Giorgio

AU - Porta, Carla

AU - Pratesi, Carlo

AU - Pruner, Gianguido

AU - Ragazzi, Giovanni

AU - Righini, Paolo

AU - Salvini, Mauro

AU - Scovazzi, Paolo

AU - Setacci, Carlo

AU - Settembrini, Alberto Maria

AU - Siani, Andrea

AU - Silingardi, Roberto

AU - Silvestro, Antonino

AU - Talarico, Francesco

AU - Tolva, Valerio

AU - Trani, Antonio

AU - Trimarchi, Santi

AU - Tshomba, Yamume

AU - Vigliotti, Gennaro

AU - Viola, Daniela

AU - Volpe, Pietro

AU - Zani, Federico

PY - 2022

Y1 - 2022

N2 - Objective: The aim was to demonstrate contemporary outcomes of in situ saphenous vein bypass using a valvulotome.Methods: Analysis of two year outcomes of a multicentre registry based on the treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique (LIMBSAVE). Between January 2018 and December 2019, 541 patients in 43 centres were enrolled. In all patients an innovative valvulotome was used. Early outcomes were assessed. Two year outcomes according to KaplaneMeier curves in terms of patency and limb salvage were evaluated. Associations between patient and procedure variables were analysed with univariable and multivariable analyses.Results: In all cases, a valvulotome was able to lyse the valves. Vein injury due to the in situ technique was 3.5%. Thirty day mortality and major amputation rates were 3% and 0.9%, respectively. Mean follow up was 12.1 months. Two year estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 69.1%, 81.4%, 86.5%, and 94.5%, respectively. Multivariable analysis showed an association between pre-operative vein diameter < 3 mm and lower primary patency (hazard ration [HR] 14.3, p <.001), primary assisted patency (HR 9.4, p = .002), secondary patency (HR 7.2, p =. 07), and limb salvage (HR 7.8, p = .005) rates. Distal anastomosis to a tibial or foot vessel was also associated with lower primary patency (HR 4.8, p = .033), and primary assisted patency (HR 6, p = .011) rates. Use of a suprafascial tributary collateral as a graft was associated with lower primary patency (HR 6.7, p = .013), and primary assisted patency (HR 4.2, p = .042) rates.Conclusion: Vein diameter < 3 mm, distal anastomosis on a tibial or foot vessel, and use of a suprafascial tributary collateral as a graft were significantly associated with loss of patency and limb loss during follow up.

AB - Objective: The aim was to demonstrate contemporary outcomes of in situ saphenous vein bypass using a valvulotome.Methods: Analysis of two year outcomes of a multicentre registry based on the treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique (LIMBSAVE). Between January 2018 and December 2019, 541 patients in 43 centres were enrolled. In all patients an innovative valvulotome was used. Early outcomes were assessed. Two year outcomes according to KaplaneMeier curves in terms of patency and limb salvage were evaluated. Associations between patient and procedure variables were analysed with univariable and multivariable analyses.Results: In all cases, a valvulotome was able to lyse the valves. Vein injury due to the in situ technique was 3.5%. Thirty day mortality and major amputation rates were 3% and 0.9%, respectively. Mean follow up was 12.1 months. Two year estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 69.1%, 81.4%, 86.5%, and 94.5%, respectively. Multivariable analysis showed an association between pre-operative vein diameter < 3 mm and lower primary patency (hazard ration [HR] 14.3, p <.001), primary assisted patency (HR 9.4, p = .002), secondary patency (HR 7.2, p =. 07), and limb salvage (HR 7.8, p = .005) rates. Distal anastomosis to a tibial or foot vessel was also associated with lower primary patency (HR 4.8, p = .033), and primary assisted patency (HR 6, p = .011) rates. Use of a suprafascial tributary collateral as a graft was associated with lower primary patency (HR 6.7, p = .013), and primary assisted patency (HR 4.2, p = .042) rates.Conclusion: Vein diameter < 3 mm, distal anastomosis on a tibial or foot vessel, and use of a suprafascial tributary collateral as a graft were significantly associated with loss of patency and limb loss during follow up.

KW - Critical limb threatening ischaemia

KW - Peripheral bypass

KW - Limb salvage

KW - In situ saphenous vein

KW - Critical limb threatening ischaemia

KW - Peripheral bypass

KW - Limb salvage

KW - In situ saphenous vein

UR - http://hdl.handle.net/10807/249254

U2 - 10.1016/j.ejvs.2022.06.004

DO - 10.1016/j.ejvs.2022.06.004

M3 - Article

SN - 1078-5884

VL - 64

SP - 350

EP - 358

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

ER -

Troisi N, Adami D, Michelagnoli S, Berchiolli R, Accrocca F, Amico A et al. Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry. European Journal of Vascular and Endovascular Surgery. 2022;64:350-358. doi: 10.1016/j.ejvs.2022.06.004

Factors Affecting Patency of In Situ Saphenous Vein Bypass: Two Year Results from LIMBSAVE (Treatment of critical Limb Ischaemia with infragenicular Bypass adopting in situ SAphenous VEin technique) Registry

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Keywords

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