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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Related Experiment Video

Updated: May 22, 2026

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

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Outcomes and practice patterns in patients undergoing lower extremity bypass.

Jessica P Simons1, Andres Schanzer, Brian W Nolan

  • 1Division of Vascular and Endovascular Surgery, University of Massachusetts, Medical School, Worcester, MA, USA.

Journal of Vascular Surgery
|May 22, 2012
PubMed
Summary

Lower extremity bypass (LEB) for intermittent claudication (IC) increased, with more patients having prior endovascular interventions. Outcomes for LEB in critical limb ischemia (CLI) and IC remained excellent over seven years.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Peripheral Artery Disease

Background:

  • The optimal revascularization strategy for peripheral artery disease (PAD), including critical limb ischemia (CLI) and intermittent claudication (IC), remains debated.
  • Large-scale data on lower extremity bypass (LEB) outcomes are essential for guiding clinical decisions.

Purpose of the Study:

  • To evaluate early and 1-year outcomes of infrainguinal lower extremity bypass (LEB).
  • To analyze trends in LEB utilization, including its use after endovascular interventions, for CLI and IC.

Main Methods:

  • Retrospective analysis of the Vascular Study Group of New England database (2003-2009).
  • Identification of 2907 infrainguinal LEB procedures.
  • Primary endpoint: 1-year amputation-free survival (AFS). Secondary endpoints: in-hospital mortality and morbidity.
  • Trend analyses stratified by indication (CLI vs. IC) and prior interventions.

Main Results:

  • LEB for IC increased from 19% to 31% (P < .0001) between 2003 and 2009.
  • Proportion of LEBs performed after prior endovascular intervention rose significantly for both CLI (11% to 24%) and IC (13% to 23%).
  • In-hospital outcomes and 1-year AFS remained stable and excellent for both IC and CLI indications.

Conclusions:

  • Significant shifts in LEB patient selection and treatment pathways occurred between 2003 and 2009.
  • Increased utilization of LEB for IC and a greater likelihood of prior endovascular intervention preceding bypass were observed.
  • LEB continues to demonstrate excellent in-hospital and 1-year outcomes for both CLI and IC.