COMPARISON OF ENDOVASCULAR INTERVENTION AND DISTAL-LEG BYPASS FOR BELOW-THE-KNEE CHRONIC LIMB-THREATENING ISCHEMIA.

Area of Science:

• Vascular Surgery
• Interventional Cardiology

Background:

• Chronic limb-threatening ischemia (CLTI) is a leading cause of major amputation.
• Below-the-knee (BTK) interventions currently have suboptimal patency rates.

Purpose of the Study:

• To compare six-month and one-year primary patency and major amputation rates.
• Evaluate outcomes of distal-leg bypass versus BTK endovascular intervention for CLTI.

Main Methods:

• Retrospective single-center study.
• Analyzed 46 patients with CLTI undergoing BTK intervention (9 bypass, 23 endovascular).
• Assessed primary patency and major amputation rates at 6 and 12 months.

Main Results:

• One-year primary patency: 55% for bypass vs. 69% for endovascular (p=0.46).
• One-year major amputation rate: 33% for bypass vs. 22% for endovascular.
• No statistically significant differences were observed between the two methods.

Conclusions:

• Endovascular intervention may offer better outcomes for BTK CLTI compared to bypass.
• Larger randomized trials with extended follow-up are warranted to validate these findings.