Comparison of angioplasty and bypass surgery for critical limb ischaemia in patients with infrapopliteal peripheral artery disease

• DOI: 10.1002/bjs.10292
• Publication Date: 2016-09-21T07:17:46Z
• Authors: S D Patel; L Biasi; I Paraskevopoulos; J Silickas; T Lea; A Diamantopoulos; K Katsanos; H Zayed
• Keywords: Critical limb ischemia; Bypass surgery

Abstract Background Both infrapopliteal (IP) bypass surgery and percutaneous transluminal angioplasty have been shown to be effective in patients with critical limb ischaemia (CLI). The most appropriate method of revascularization has yet established, as no randomized trials reported. aim this study was compare the outcomes similar characteristics treated using either method. Methods Consecutive undergoing IP for CLI (Rutherford 4–6) at a single institution were compared following propensity score matching. endpoints primary, assisted primary secondary patency, amputation-free survival 12 months, calculated by Kaplan–Meier analysis. Results Some 279 limbs 243 included study. two groups differed significantly respect incidence diabetes (P = 0·024), estimated glomerular filtration rate 0·006), total lesion length < 0·001) Rutherford classification 0·008). These factors used construct model, which yielded matched cohort 125 legs each group. Primary patency (54·4 versus 51·4 per cent; P 0·014), (77·5 62·7 0·003), (84·4 65·8 (78·7 74·1 0·043) better after than angioplasty. However, salvage (90·4 94·2 0·161), overall complications (36·0 21·6 0·041) well hospital stay (18(4–134) 5(0–110); worse surgical Conclusion There difference rates, but rates 1 year surgery.