Related Experiment Video
Updated: Apr 23, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Objective performance goals after open and endovascular intervention for critical limb ischaemia
Eike Sebastian Debus1, Jasmin Epple2, Carl-Leon Reese1
1University Heart and Vascular Centre Hamburg, Department for Vascular Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Insights
This study compared critical limb ischemia treatments, lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI), against Society for Vascular Surgery objective performance goals (OPG). Both LEB and IEI largely met OPGs, with no significant 5-year outcome differences.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- Critical limb ischemia (CLI) poses significant risks, necessitating effective treatment strategies.
- Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are primary revascularization methods for CLI.
- The Society for Vascular Surgery established objective performance goals (OPGs) to benchmark treatment efficacy.
Purpose of the Study:
- To evaluate if current real-world treatments for CLI, specifically LEB and IEI, align with established SVS OPGs.
- To compare perioperative and long-term outcomes of LEB and IEI against OPG benchmarks.
- To assess amputation-free survival (AFS) and patient survival rates for both interventions.
Main Methods:
- A comprehensive literature search was conducted in PubMed for studies published between 2010 and March 2021.
- Data from 82 publications on 35,981 IEI procedures and 49 publications on 26,707 LEB procedures were analyzed.
- Outcomes including perioperative adverse events, AFS, and patient survival were compared to SVS OPGs.
Main Results:
- Perioperative major adverse limb events showed no significant difference between IEI (9%) and LEB (10%) compared to OPG (8%).
- Perioperative major adverse cardiovascular events were significantly better for both IEI (4%) and LEB (6%) than OPG (8%).
- One-year AFS was 71% for IEI and 77% for LEB, while patient survival was 78% for IEI and 84% for LEB, with varying statistical significance against OPGs. Five-year survival and AFS did not differ significantly between LEB and IEI.
Conclusions:
- Real-world outcomes for infrainguinal endovascular intervention (IEI) and lower extremity bypass (LEB) largely align with Society for Vascular Surgery objective performance goals (OPGs).
- No significant differences were observed in 5-year outcomes between LEB and IEI for critical limb ischemia.
- Both LEB and IEI represent viable treatment options for CLI, meeting established performance benchmarks.
Abstract:
Background: Whether current real-world treatment of critical limb ischemia with lower extremity bypass (LEB) or infrainguinal endovascular intervention (IEI) meets the Society for Vascular Surgery objective performance goals (OPG) was investigated. Materials and methods: Literature search in PubMed, studies from 2010 to March 2021. A total of 35,981 endovascular interventions were reported in 82 publications and 26,707 open procedures in 49 publications. Results: Perioperative major adverse limb events was 8% (OPG) versus 9% for IEI and 10% for LEB (no significant differences). Perioperative major adverse cardiovascular events was significantly better with IEI (4%; p < .001) and LEB (6%; p = .018) than the OPG (8%). After 1 year, amputation-free survival (AFS) was 76.5% (OPG), compared to 71% with IEI (p = .932) and 77% with LEB (p = .006) and patient survival was 85.7% (OPG) compared to 84% (LEB; p = .006) and 78% (IEI; p = .102). 5-year survival was 51% with LEB and 45% with IEI (p = .320), and AFS was 44% with LEB and 46% with IEI (p = .802). 5-year OPGs were not reported. Conclusions: In the studies analysed, the results after IEI and LEB largely corresponded to the OPGs. 5-year outcomes after LEB and IEI did not differ significantly.
More Related Videos
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:27Peripheral Artery Disease III: Interprofessional Care
01:26Peripheral Artery Disease IV: Nursing Management