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Related Experiment Video

Updated: Jul 19, 2025

Cerenkov Luminescence Imaging CLI for Cancer Therapy Monitoring

Cerenkov Luminescence Imaging CLI for Cancer Therapy Monitoring

Published on: November 13, 2012

Contextualizing the BEST-CLI Trial Results in Clinical Practice.

Neel M Butala¹, Venita Chandra², Joshua A Beckman³

¹Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Journal of the Society for Cardiovascular Angiography & Interventions

|August 14, 2023

Summary

This summary is machine-generated.

The BEST-CLI trial

Keywords:

chronic limb-threatening ischemia endovascular outcomes revascularization

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Area of Science:

Vascular Surgery
Interventional Cardiology
Health Services Research

Background:

Chronic limb-threatening ischemia (CLTI) presents significant long-term challenges.
Optimal revascularization strategies for CLTI remain under investigation.
The generalizability of the BEST-CLI trial to the broader CLTI population requires evaluation.

Purpose of the Study:

To assess the generalizability of the BEST-CLI trial findings to Medicare beneficiaries with CLTI.
To compare revascularization outcomes in a real-world Medicare population versus the BEST-CLI trial cohorts.
To evaluate the effectiveness of endovascular versus surgical revascularization in older adults with CLTI.

Main Methods:

Retrospective analysis of Medicare beneficiaries (65-85 years) with CLTI undergoing revascularization (2016-2019).
Primary exposure: endovascular revascularization vs. autologous vs. nonautologous grafts.
Primary outcome: composite of major adverse limb events (MALE) and death.

Main Results:

The Medicare cohort was older, more female, and had more comorbidities than the BEST-CLI trial participants.
Crude risk of death or MALE was higher with surgical revascularization in the Medicare cohort compared to BEST-CLI.
Endovascular treatment in the Medicare cohort showed a similar risk of death or MALE but a significantly lower risk of major intervention compared to the BEST-CLI trial.

Conclusions:

BEST-CLI trial findings may not fully represent the outcomes for the entire Medicare population with CLTI.
Real-world outcomes for surgical revascularization in Medicare beneficiaries with CLTI appear worse than in the BEST-CLI trial.
Endovascular revascularization demonstrated favorable outcomes, particularly regarding major interventions, in the Medicare population compared to the trial data.