Comparison of long occlusive femoropopliteal de novo versus previous endovascularly treated lesions managed with in situ saphenous bypass

Nicola Troisi, Stefano Michelagnoli, Daniele Adami, 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

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background: The aim of this study was to compare the 2-year outcomes of de novo versus postendovascular lesion treatment of femoropopliteal occlusions included in a national, multicenter, observational, prospective registry based on the treatment of critical Limb-threatening IschaeMia with infragenicular Bypass adopting in situ SAphenous VEin technique (LIMBSAVE) registry.Methods: From January 2018 to December 2019, 541 patients from43 centers have been enrolled in the LIMBSAVE registry. Of these patients, 460 were included in the present study: 341 (74.1%) with de novo lesions (DN group) and 119 (25.9%) with postendovascular treatment lesions (PE group). Initial outcome measures were assessed at 30 days after treatment. Furthermore, at the 2-year follow-up, the estimated outcomes of primary patency, primary-assisted patency, secondary patency, and limb salvage were analyzed with Kaplan-Meier curves and compared between groups with the log-rank test.Results: Both groups were homogeneous in terms of demographic data, preoperative risk factors, and clinical presentation. However, compared with DN group, more patients in PE group had a great saphenous vein diameter of less than 3 mm (11.1% vs 21%; P = .007). Intraoperatively, both groups showed similar distal anastomosis sites: below-the-knee popliteal artery (63% DN group, 66.4% PE group) and tibial vessel (37% DN group, 33.6% PE group) (P = .3). The overall mean duration of follow-up was 11.6 months (range, 1-24 months). At the 2-year follow-up, there were no differences between the two groups in terms of primary patency (66.3% DN group vs 74.1% PE group; P = .9), primary-assisted patency (78.2% DN group vs 79.5% PE group; P = .2), secondary patency (85.1% DN group vs 91.4% PE group; P = .2), and limb salvage (95.2% DN group vs 95.1% PE group; P = .9).Conclusions: The LIMBSAVE registry did not show a worsening of overall patency and limb salvages rates at the 2-year follow-up in patients undergoing in situ saphenous bypass after a failed endovascular approach for long femoropopliteal occlusive disease. This finding is in contrast with what has been published in literature.
Lingua originaleEnglish
pagine (da-a)797-805
Numero di pagine9
RivistaJournal of Vascular Surgery
Volume76
DOI
Stato di pubblicazionePubblicato - 2022

Keywords

  • Critical limb-threatening ischemia
  • Peripheral bypass
  • Limb salvage
  • In situ saphenous vein

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