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Distal Bypass Versus Infrageniculate Endovascular Intervention for Chronic Limb-Threatening Ischemia

Young Kim1, Charles S Decarlo1, Karthik Thangappan1

  • 1Division of Vascular and Endovascular Surgery, Harvard Medical School, 548305Massachusetts General Hospital, Boston, MA. USA.

Vascular and Endovascular Surgery
|March 31, 2022
PubMed

Insights

Chronic limb-threatening ischemia (CLTI) requires urgent treatment to prevent amputation. This review compares open bypass surgery with endovascular therapy for infrageniculate tibial arterial disease in CLTI patients.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapy

Background:

  • Chronic limb-threatening ischemia (CLTI) presents a significant risk of major limb amputation.
  • Involvement of infrageniculate vessels in CLTI escalates amputation risk.
  • Tibial arterial disease necessitates effective treatment strategies.

Purpose of the Study:

  • To review and compare open surgical bypass and endovascular interventions for CLTI.
  • To evaluate treatment options for infrageniculate tibial arterial disease.
  • To provide an overview of current literature for high-risk CLTI patients.

Main Methods:

  • Literature review of studies on distal bypass and infrageniculate endovascular intervention.
  • Analysis of treatment outcomes in patients with CLTI.
  • Comparison of open surgical versus endovascular approaches.

Main Results:

  • Open surgical bypass is the traditional standard for tibial arterial disease.
  • Endovascular therapy offers a viable alternative for high-risk CLTI patients.
  • Review focuses on outcomes for infrageniculate interventions.

Conclusions:

  • Endovascular therapy is an attractive option for CLTI patients with infrageniculate disease.
  • Treatment choice depends on patient-specific factors and disease severity.
  • Further research may refine treatment algorithms for CLTI.

Keywords:
Chronic limb-threatening ischemiadistal bypassinfrageniculate endovascular interventionpedal accesspedal bypass

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